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Annual Cost of U.S. Hospital Visits for Pediatric Abusive Head Trauma
Cora Peterson1, Likang Xu2, Curtis Florence2
1Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control, Atlanta, GA, USA cora.peterson@cdc.hhs.gov.
Insights
Pediatric abusive head trauma (AHT) resulted in an estimated 6,827 emergency department visits and 12,533 hospital admissions annually in the U.S. These AHT cases incurred substantial medical costs, highlighting the need for targeted prevention strategies.
Area of Science:
- Pediatrics
- Public Health
- Health Economics
Background:
- Abusive head trauma (AHT) is a severe form of child abuse with significant healthcare utilization.
- Estimating the economic burden of AHT is crucial for resource allocation and intervention planning.
Purpose of the Study:
- To estimate the frequency and direct medical costs of U.S. hospital visits for pediatric abusive head trauma (AHT) from a provider's perspective.
- To identify patient and hospital characteristics associated with higher per-visit costs for AHT.
Main Methods:
- Utilized data from the Nationwide Emergency Department Sample and Nationwide Inpatient Sample (NIS) for 2006-2011.
- Applied cost-to-charge ratios and professional fee ratios to estimate per-visit and total population costs.
- Employed regression models to analyze cost differences based on patient and hospital factors.
Main Results:
- An estimated 6,827 emergency department (ED) visits and 12,533 hospital admissions for AHT occurred annually among children aged 0-4 years.
- Average medical costs were $2,612 per ED visit and $31,901 per admission.
- Total annual nationwide medical costs for AHT hospital visits averaged $69.6 million.
Conclusions:
- Pediatric abusive head trauma represents a significant financial burden on the healthcare system.
- Higher costs were associated with younger age, male sex, comorbidities, complex discharge, mortality, higher income, public insurance, and hospital trauma level/location.
- Findings underscore the necessity of targeted interventions to mitigate the incidence and associated costs of AHT.
Abstract:
We estimated the frequency and direct medical cost from the provider perspective of U.S. hospital visits for pediatric abusive head trauma (AHT). We identified treat-and-release hospital emergency department (ED) visits and admissions for AHT among patients aged 0-4 years in the Nationwide Emergency Department Sample and Nationwide Inpatient Sample (NIS), 2006-2011. We applied cost-to-charge ratios and estimated professional fee ratios from Truven Health MarketScan(®) to estimate per-visit and total population costs of AHT ED visits and admissions. Regression models assessed cost differences associated with selected patient and hospital characteristics. AHT was diagnosed during 6,827 (95% confidence interval [CI] [6,072, 7,582]) ED visits and 12,533 (95% CI [10,395, 14,671]) admissions (28% originating in the same hospital's ED) nationwide over the study period. The average medical cost per ED visit and admission were US$2,612 (error bound: 1,644-3,581) and US$31,901 (error bound: 29,266-34,536), respectively (2012 USD). The average total annual nationwide medical cost of AHT hospital visits was US$69.6 million (error bound: 56.9-82.3 million) over the study period. Factors associated with higher per-visit costs included patient age <1 year, males, coexisting chronic conditions, discharge to another facility, death, higher household income, public insurance payer, hospital trauma level, and teaching hospitals in urban locations. Study findings emphasize the importance of focused interventions to reduce this type of high-cost child abuse.
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