Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Using medical billing data to evaluate chronically ill children over time.

John M Neff1, Virginia L Sharp, Jean Popalisky

  • 1Center for Children with Special Needs, Children's Hospital and Regional Medical Center, Department of Pediatrics, University of Washington, Seattle, 98101, USA. john.neff@seattlechildrens.org

The Journal of Ambulatory Care Management
|September 21, 2006
PubMed
Summary

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Measures of ED utilization in a national cohort of children.

The American journal of managed care·2020
Same author

Medicaid Expenditures Among Children With Noncomplex Chronic Diseases.

Pediatrics·2018
Same author

Health Care Expenditures and Utilization for Children With Noncomplex Chronic Disease.

Pediatrics·2017
Same author

Development and Validation of the Pediatric Medical Complexity Algorithm (PMCA) Version 2.0.

Hospital pediatrics·2017
Same author

A Framework for Evaluating Value of New Clinical Recommendations.

Hospital pediatrics·2016
Same author

Trends in Health Care Spending for Children in Medicaid With High Resource Use.

Pediatrics·2016

Chronic condition identification in children over 4 years old shows variability. While catastrophic conditions were stable, minor and moderate ones fluctuated, with many improving over time.

Area of Science:

  • Pediatric Health Services Research
  • Health Informatics
  • Chronic Disease Epidemiology

Background:

  • Accurate identification of chronic conditions in pediatric populations is crucial for effective healthcare management and resource allocation.
  • Health plan billing data offers a large-scale, longitudinal source for analyzing disease prevalence and stability over time.
  • Clinical Risk Groups (CRGs) provide a framework for stratifying patient complexity and predicting healthcare needs.

Purpose of the Study:

  • To evaluate the stability of chronic condition identification among children older than 4 years using health plan billing data.
  • To assess the longitudinal changes in chronic condition status within a pediatric cohort over a four-year period.
  • To identify patterns of stability and change in chronic conditions, differentiating by severity and type.

Related Experiment Videos

Main Methods:

  • Utilized health plan billing data for a cohort of 31,055 children continuously enrolled for four years.
  • Employed Clinical Risk Groups (CRGs) to categorize and track chronic condition status annually.
  • Analyzed the proportion of children identified with chronic conditions at baseline and subsequent years, and tracked changes in status.

Main Results:

  • 7.5% of children were identified with a chronic condition in the first year, with an additional 15.4% identified in subsequent years.
  • 63.6% of the cohort remained consistently identified as 'healthy' throughout the four-year study period.
  • Children with catastrophic health conditions exhibited the most stable identification, whereas those with minor or moderate/dominant major chronic conditions showed less stability. Notably, 73.1% of children with initial chronic conditions improved their status, while 5.7% progressed to more complex conditions.

Conclusions:

  • Chronic condition identification in children over 4 years old, as assessed by CRGs in billing data, demonstrates significant variability.
  • The stability of chronic condition status differs markedly by condition severity, with less severe conditions being more dynamic.
  • A substantial proportion of children initially identified with chronic conditions experience improvement, highlighting the need for dynamic monitoring and reassessment.