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Effect of multiple chronic diseases on health care expenditures in childhood
Wenjun Zhong1, Dawn M Finnie1, Nilay D Shah1
1Mayo Clinic, Rochester, MN, USA.
Insights
Children with multiple chronic conditions drive significant healthcare costs. A small group of these children consistently incurred high healthcare expenditures over a four-year period.
Area of Science:
- Pediatric healthcare research
- Health economics
- Chronic disease management
Background:
- Multiple chronic conditions (MCCs) in children represent a growing public health concern.
- Understanding the economic burden of MCCs in pediatric populations is crucial for resource allocation.
- Previous studies have not fully elucidated the long-term healthcare expenditure patterns associated with pediatric MCCs.
Purpose of the Study:
- To investigate the prevalence of various chronic conditions in children.
- To analyze the associated healthcare expenditures for children with single versus multiple chronic conditions.
- To identify trends in healthcare spending among children with MCCs over a defined period.
Main Methods:
- Retrospective cohort study utilizing claims data from dependents of Mayo Clinic employees (aged 0-17).
- Analysis included 14,727 children with continuous health benefits coverage for four years.
- Data on chronic conditions, healthcare utilization, and expenditures were extracted from medical and pharmacy claims.
Main Results:
- The most common chronic conditions identified were asthma/chronic obstructive pulmonary disease (12%), allergic rhinitis (11%), and behavior problems (9%).
- Congenital anomalies, asthma/COPD, and behavior problems were the costliest conditions, with annual costs per child ranging from $4,335 to $9,602.
- Healthcare expenditures significantly increased with the number of chronic conditions, with a small subset of children with MCCs accounting for a disproportionately large share of total costs.
Conclusions:
- Children with multiple chronic conditions represent a substantial portion of pediatric healthcare expenditures.
- These children demonstrated a higher likelihood of remaining high-cost spenders over the four-year study duration.
- Further research is warranted to develop effective healthcare delivery models for children managing multiple chronic conditions.
Objectives:
To examine multiple chronic conditions and related health care expenditures in children.
Methods:
Retrospective cohort study of all dependents of Mayo Clinic employees aged 0-17 on Jan 1, 2004 with continuous health benefits coverage for 4 years (N=14,727). Chronic conditions, health care utilization, and associated expenditures were obtained from medical and pharmacy claims.
Results:
The most prevalent chronic conditions were asthma/chronic obstructive pulmonary disease (12%), allergic rhinitis (11%), and behavior problems (9%). The most costly conditions were congenital anomalies, asthma/chronic obstructive pulmonary disease, and behavior problems ($9602, $4335, and $5378 annual cost per child, respectively). Annual health care expenditures increased substantially with the number of chronic conditions, and a small proportion of children with multiple chronic conditions accounted for a large proportion of health care costs. In addition, those with multiple chronic conditions were more likely to persist in the top 10th percentile spender group in year-to-year spending.
Conclusion:
Children with multiple chronic conditions accounted for a large proportion of health care expenditures. These children were also likely to persist as high spenders in the 4-year time frame. Further research into effective ways to manage the health care delivery for children with multiple chronic conditions is needed.
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