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Development of Hospitalization Resource Intensity Scores for Kids (H-RISK) and Comparison across Pediatric

Troy Richardson1, Jonathan Rodean2, Mitch Harris2

  • 1Children's Hospital Association, Lenexa, Kansas and Washington, DC, USA. troy.richardson@childrenshospitals.org.

Journal of Hospital Medicine
|April 26, 2018
PubMed

Insights

New hospitalization resource intensity scores for kids (H-RISK) effectively identify differences in pediatric patient severity of illness (SOI) across hospital types. This tool aids in understanding pediatric healthcare resource utilization.

Area of Science:

  • Pediatric Healthcare Research
  • Health Services Research
  • Medical Economics

Background:

  • Severity of illness (SOI) measures are crucial for Medicare prospective payment models.
  • Standardized measures for pediatric patient SOI are underdeveloped.
  • This study addresses the need for pediatric-specific resource intensity scoring.

Purpose of the Study:

  • To develop hospitalization resource intensity scores for kids (H-RISK).
  • To create pediatric relative weights (RWs) for SOI.
  • To compare case-mix index (CMI) across different hospital types.

Main Methods:

  • Utilized the 2012 Kids' Inpatient Database (KID).
  • Developed RWs for each All Patient Refined Diagnosis Related Group (APR-DRG) and SOI level.
  • Calculated hospital-level CMIs by averaging RWs and compared across hospital types.

Main Results:

  • The overall adjusted mean cost was $6,135 per discharge.
  • Transplantations and neonatal conditions had the highest procedural and medical RWs, respectively.
  • Free-standing children's hospitals showed the highest median CMI (2.7), followed by urban teaching (1.8), urban non-teaching (1.1), and rural hospitals (0.8).

Conclusions:

  • H-RISK scores are sensitive to variations in pediatric patient SOI.
  • The developed scores can differentiate resource intensity across hospital types.
  • This facilitates a better understanding of pediatric healthcare resource allocation.
Abstract

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