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Comparative costs of treating adults and children within selected diagnosis-related groups
Donald S Young1, Bruce S Sachais, Leigh C Jefferies
1Department of Pathology and Laboratory Medicine, University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104-4283, USA. donaldyo@mail.med.upenn.edu
Insights
Pediatric patients generally incur lower hospitalization costs than adults for similar conditions. Adults had higher costs for radiology, laboratory, and pharmacy services, with greater cost variability observed in pediatric care.
Area of Science:
- Health Economics
- Pediatric Hospitalization Costs
- Comparative Healthcare Analysis
Background:
- Limited large-scale analyses exist comparing resource utilization and costs between pediatric and adult patient populations.
- Previous studies have not evaluated specific hospitalization cost components (e.g., accommodation, lab, radiology, drugs) across age groups.
Purpose of the Study:
- To investigate the effect of patient age on the overall costs of hospital treatment.
- To compare the costs of various non-physician components of hospitalization between pediatric and adult patients.
Main Methods:
- Analysis of 43 matched diagnosis-related groups (DRGs) for pediatric and adult patients.
- Utilized University HealthSystems Consortium database for 1,346,028 admissions across 60 university hospitals.
- Examined non-physician costs including accommodation, surgery, pharmacy, radiology, and laboratory, derived from cost-to-charge ratios.
Main Results:
- Adult patients generally incurred higher total non-physician hospitalization costs than pediatric patients within matched DRGs.
- Radiology, laboratory, and pharmacy costs were notably higher for adults, particularly on a per diem basis.
- Greater cost variability was observed in pediatric patient treatment compared to adults within matched DRGs.
Conclusions:
- Hospitalization costs for pediatric patients are typically lower than for adults with comparable nominal conditions in university hospitals.
- Pediatric patients, on average, utilized fewer laboratory, radiology, and pharmacy services compared to adult patients.
Background:
There have been no large-scale analyses of resource utilization comparing the overall costs to treat pediatric patients vs adult patients. Likewise, there have been no studies evaluating the costs of the various components of hospitalization (e.g., accommodation, laboratory, radiology, and drugs) among adult and pediatric populations.
Methods:
To study the effect of age on the costs of treating patients, we have evaluated 43 conditions with matching diagnosis-related groups (DRGs) for children and adults. Using a database developed by the University HealthSystems Consortium, we examined the major non-physician components of hospital costs, including accommodation, surgery, pharmacy, radiology, and laboratory for 1,346,028 patient admissions to 60 University hospitals. These costs were derived from the ratio of costs to charges based on the Centers for Medicare and Medicaid Services PPS UB-2 cost reports.
Results:
The total non-physician cost of treating adults was generally greater than that for children within paired DRGs. Some of this difference may be attributable to the overall longer stay of adults in hospital. For conditions that were nominally the same, radiology, laboratory, and drug costs, especially tended to be higher for adults than for children. This was most marked when the costs were evaluated on a per diem basis. There tended to be greater variability in the costs of treating children than adults within the paired DRGs, as evidenced by greater differences between the median and mean costs.
Conclusions:
Among University hospitals, the costs of managing children are typically less than for adults with the same nominal condition. In these hospitals, there tends to be less use of laboratory, radiology, and pharmacy services for children than for adults.