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Published on: November 4, 2010
Cost of hospitalization for bronchiectasis exacerbation in children
Vikas Goyal1,2,3, Steven M McPhail4,5, Frank Hurley6
1Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, Brisbane, QLD, Australia.
Insights
Hospitalizations for pediatric bronchiectasis exacerbations are costly, averaging over AUD 30,000 per episode. Shorter hospital stays and fewer affected lung lobes can reduce these significant healthcare costs.
Area of Science:
- Pediatric Pulmonology
- Health Economics
- Epidemiology
Background:
- Paediatric bronchiectasis is increasingly recognized globally.
- Limited data exists on hospitalization costs for pediatric bronchiectasis.
Purpose of the Study:
- To identify health service costs of hospitalizations for pediatric bronchiectasis exacerbations.
- To determine factors associated with these hospitalization costs in children.
Main Methods:
- Prospective data collection on 100 hospitalizations in 80 children (<18 years) at a Queensland paediatric hospital.
- Analysis of demographic data, hospital resource use, and direct health service costs (2016 AUD).
- Linear regression with bootstrap resampling to identify cost-associated factors.
Main Results:
- The mean direct health service cost was AUD 30,182 per hospitalization (12.30 days length of stay).
- Health professional wages constituted 70% of the cost per episode.
- Longer length of stay, younger age, and more affected lung lobes increased costs; Home and Community Care services reduced costs.
Conclusions:
- Hospitalizations for pediatric bronchiectasis exacerbations represent a substantial healthcare cost burden.
- Interventions preventing exacerbations and reducing disease severity can lead to significant cost savings.
Background And Objective:
Despite paediatric bronchiectasis being recognized increasingly worldwide, prior reports of hospitalization costs for bronchiectasis in children are lacking. This study aimed to (i) identify health service costs of hospitalizations and (ii) factors associated with these costs in children admitted to an Australian paediatric hospital following an acute exacerbation of their bronchiectasis.
Methods:
Demographic and hospital resource use data were prospectively recorded for 100 hospitalizations in 80 children aged <18 years admitted consecutively to the QCH, Brisbane, Australia. Costs (2016 AUD) were obtained from the hospital's Finance Department. Linear regressions, with bootstrap resampling to quantify uncertainty, were used to estimate factors affecting cost of hospitalization.
Results:
The 100 hospitalizations (48 males) had a median (IQR) age of 6.04 (4.04-9.85) years. Their mean (SD) LOS was 12.30 (4.60) days. The mean (SD) direct health service cost was AUD 30 182 (13 998) per hospitalization. The greatest contributor to costs was health professional wages, accounting for 70% of the cost per episode. LOS, younger age at admission and number of bronchiectatic lobes affected were associated with higher costs, whilst HITH service was associated with lower cost. The cost to families on average was AUD 2669.50 (SD: 991.50) per hospitalization when accounting for lost wages and opportunity cost.
Conclusion:
The per episode healthcare cost burden of hospitalizations for paediatric bronchiectasis exacerbations is substantial. Interventions that prevent hospitalized exacerbations and reduce severity of childhood bronchiectasis with even moderate effectiveness are likely to result in substantial hospital costs savings.
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