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Published on: June 30, 2014
Comprehensive population-based determination of pediatric multiple sclerosis health care costs
Melissa A Wright1, E Kent Korgenski1, Tyler Bardsley1
1School of Medicine (M.A.W.), Study Design and Biostatistics Center (T.B.), Department of Biostatistics (T.B.), and Department of Pediatrics, Division of Pediatric Neurology (J.L.B., M.S.C.), University of Utah; and Intermountain Healthcare (E.K.K.), Salt Lake City.
Insights
Pediatric multiple sclerosis (MS) care is costly, with a small group of patients driving expenses. Outpatient visits are the main cost driver, though inpatient stays are more expensive per event.
Area of Science:
- Pediatric Neurology
- Health Economics
- Epidemiology
Background:
- Pediatric multiple sclerosis (MS) represents a significant health challenge with substantial economic implications.
- Understanding the financial burden is crucial for resource allocation and patient support.
Purpose of the Study:
- To quantify the health care costs associated with pediatric multiple sclerosis (MS).
- To identify key drivers of these costs within a defined population.
Main Methods:
- Retrospective analysis of pediatric MS patients (≤18 years) diagnosed/treated between 2002-2012.
- Extraction of demographic and cost data from a large healthcare enterprise data warehouse.
- Comparison of health care utilization between high-cost and low-cost patient groups.
Main Results:
- Total health care costs exceeded $1.5 million for 57 pediatric MS patients over 10 years.
- The top 16% of patients accounted for nearly two-thirds of total costs.
- Outpatient visits comprised 83.1% of total expenditures, while inpatient stays were most expensive per encounter ($2,924).
Conclusions:
- Pediatric MS imposes a significant financial burden, with a disproportionate cost incurred by a small patient subset.
- Outpatient care dominates overall spending, but inpatient care carries higher per-encounter costs.
- Strategies focusing on efficient outpatient management and reducing inpatient utilization may lower costs and improve care.
Objective:
To determine the health care costs associated with pediatric multiple sclerosis (MS).
Methods:
We performed a retrospective analysis of all patients with MS 18 years of age or younger who were diagnosed or treated between 2002 and 2012 in a population-based cohort. Demographics and health care costs were extracted from the Intermountain Healthcare Enterprise Data Warehouse. Patients were divided into high-cost (>84th percentile) and low-cost groups and differences in health care utilization between the groups were analyzed.
Results:
Fifty-seven pediatric patients with MS were identified. Health care costs for the cohort totaled more than $1.5 million over the 10-year period, with the top 16th percentile of patients contributing nearly two-thirds. Outpatient visits represented the majority of health care encounters and expenditures, accounting for 83.1% of total costs. Costs per encounter were highest for inpatient stays, averaging $2,924 per stay.
Conclusions:
The burden of health care expenses for pediatric patients with MS is significant. Expenditures related to outpatient visits were the largest contributor to costs, but inpatient stays were the most costly per encounter. A small proportion of patients incurred the bulk of costs and spent significantly more time receiving care compared to the majority of patients. Avoidance of inpatient treatment and efficient outpatient management are potential areas for health care cost reduction and improvement in care.
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