Related Experiment Video
Updated: Oct 4, 2025
Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
Published on: August 9, 2024
Prevalence, Cost, and Variation in Cost of Pediatric Hospitalizations in Ontario, Canada
Peter J Gill1,2,3,4, Thaksha Thavam3, Mohammed Rashidul Anwar3
1Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.
Insights
Newborn and mental health conditions represent the highest burden in pediatric hospitalizations, showing significant prevalence, cost, and cost variation. This research informs a new agenda for hospitalized children
Area of Science:
- Pediatric Health Services Research
- Health Economics
- Epidemiology
Background:
- Prioritizing research for hospitalized children is crucial for developing effective care agendas.
- Existing studies are outdated and lack comprehensive data from both pediatric and general hospitals.
Purpose of the Study:
- To assess the prevalence, cost, and cost variation of pediatric hospitalizations across all Ontario hospitals.
- To identify conditions for prioritization in future pediatric research agendas.
Main Methods:
- Population-based cross-sectional study utilizing health administrative data from 165 Ontario hospitals.
- Inclusion of children under 18 with inpatient hospital encounters between April 2014 and March 2019.
- Analysis of condition-specific prevalence, hospitalization costs, and cost variation using intraclass correlation coefficient (ICC).
Main Results:
- Over 627,000 pediatric hospital encounters cost $3.3 billion, with 43.8% of costs incurred at general hospitals.
- Top conditions by prevalence and cost include low birth weight, preterm newborn, major depressive disorder, and pneumonia.
- Highest cost variation per encounter observed in mental health (other mental health disorders, anxiety disorders) and newborn conditions (intrauterine hypoxia, other perinatal conditions, surfactant deficiency disorder).
Conclusions:
- Newborn and mental health conditions exhibit the highest prevalence, cost, and cost variation in pediatric hospitalizations.
- Findings support the development of a research agenda for hospitalized children, integrating data from general hospitals.
- This evidence base can lead to improved patient outcomes and more equitable healthcare resource allocation.
Importance:
Identifying conditions that could be prioritized for research based on health care system burden is important for developing a research agenda for the care of hospitalized children. However, existing prioritization studies are decades old or do not include data from both pediatric and general hospitals.
Objective:
To assess the prevalence, cost, and variation in cost of pediatric hospitalizations at all general and pediatric hospitals in Ontario, Canada, with the aim of identifying conditions that could be prioritized for future research.
Design, Setting, And Participants:
This population-based cross-sectional study used health administrative data from 165 general and pediatric hospitals in Ontario, Canada. Children younger than 18 years with an inpatient hospital encounter between April 1, 2014, and March 31, 2019, were included.
Main Outcomes And Measures:
Condition-specific prevalence, cost of pediatric hospitalizations, and condition-specific variation in cost per inpatient encounter across hospitals. Variation in cost was evaluated using (1) intraclass correlation coefficient (ICC) and (2) number of outlier hospitals. Costs were adjusted for inflation to 2018 US dollars.
Results:
Overall, 627 314 inpatient hospital encounters (44.8% among children younger than 30 days and 53.0% among boys) at 165 hospitals (157 general and 8 pediatric) costing $3.3 billion were identified. A total of 408 003 hospitalizations (65.0%) and $1.4 billion (43.8%) in total costs occurred at general hospitals. Among the 50 most prevalent and 50 most costly conditions (of 68 total conditions), the top 10 highest-cost conditions accounted for 55.5% of all costs and 48.6% of all encounters. The conditions with highest prevalence and cost included low birth weight (86.2 per 1000 encounters; $676.3 million), preterm newborn (38.0 per 1000 encounters; $137.4 million), major depressive disorder (20.7 per 1000 encounters; $78.3 million), pneumonia (27.3 per 1000 encounters; $71.6 million), other perinatal conditions (68.0 per 1000 encounters; $65.8 million), bronchiolitis (25.4 per 1000 encounters; $54.6 million), and neonatal hyperbilirubinemia (47.9 per 1000 encounters; $46.7 million). The highest variation in cost per encounter among the most costly medical conditions was observed for 2 mental health conditions (other mental health disorders [ICC, 0.28] and anxiety disorders [ICC, 0.19]) and 3 newborn conditions (intrauterine hypoxia and birth asphyxia [ICC, 0.27], other perinatal conditions [ICC, 0.17], and surfactant deficiency disorder [ICC, 0.17]).
Conclusions And Relevance:
This population-based cross-sectional study of hospitalized children identified several newborn and mental health conditions as having the highest prevalence, cost, and variation in cost across hospitals. Findings of this study can be used to develop a research agenda for the care of hospitalized children that includes general hospitals and to ultimately build a more substantial evidence base and improve patient outcomes.
Related Concept Videos
01:28Hospitals-I
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
00:59Hospitals-II
Nurses that work in...
01:08Prevalence and Incidence
Prevalence indicates the proportion of individuals in a population who have a specific disease or health...
01:29Issues And Trends In Healthcare Delivery System
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
01:30Preventive Healthcare Services