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Characteristics and spending patterns of high-cost child patients: findings from Fujian in China
1School of Economics, Central University of Finance and Economics, Shahe Higher Education Park, Changping District, Beijing, China. xiaobopeng1212@163.com.
Insights
High childhood healthcare costs disproportionately affect a small percentage of children, particularly teenagers with complex conditions. Current risk protection and insurance are insufficient, especially for low-income families, highlighting a critical need for improved support systems.
Area of Science:
- Pediatric Health Economics
- Healthcare Expenditure Analysis
- Public Health Policy in Developing Economies
Background:
- Childhood health significantly impacts adult health and socioeconomic status.
- Understanding children's healthcare expenditure patterns is vital for risk protection and well-being.
- Existing research on healthcare cost concentration and persistence primarily focuses on elderly populations in developed nations.
Purpose of the Study:
- To investigate the characteristics and spending patterns of high-cost pediatric patients in China, the largest developing economy.
- To identify factors contributing to high healthcare expenditures among children.
- To assess the adequacy of risk protection and insurance for high-cost children.
Main Methods:
- Utilized a unique individual-level administrative claims dataset spanning five years.
- Employed linear probability and logit regression models to analyze spending concentrations and persistence in high-cost groups.
- Defined high-cost children as those in the top 10% of the expenditure distribution.
Main Results:
- Over 50% of total healthcare expenditures were concentrated among the top 10% of high-cost children.
- Teenagers (12-17 years) were more likely to remain in the high-cost group.
- Pediatric complex chronic conditions and severe health ailments were key predictors of high healthcare costs and persistence.
Conclusions:
- A significant portion of healthcare spending is attributed to a small group of high-cost pediatric patients.
- Existing healthcare insurance and risk protection measures are inadequate for these children, particularly those from low-income families.
- Findings underscore the need for targeted support for high-cost children and their families to mitigate financial burdens and improve health outcomes.
Background:
The health condition during childhood has been shown to influence an individual's health and socioeconomic status in adulthood. Understanding the concentration and persistence patterns in children's healthcare expenditures is crucial for providing risk protection and promoting the well-being of children. Studies regarding the concentration and persistence of health expenditures have focused mainly on elderly individuals in developed regions. To gain insights into factors that contribute to childhood health expenditures, this article examined children with high costs (that is, in the top 10% of the expenditure distribution) and explored the characteristics and spending patterns that distinguished them from other patients in the context of the largest developing economy-China.
Methods:
By using a unique individual-level administrative claims dataset over a 5-year observation period, this study identified spending concentrations and the proportion of children whose costs remained high over five years using a linear probability model and logit regression analysis.
Results:
Teenagers from 12 to 17 years old were more likely to persist in the high-cost group than any other age groups in the study. Pediatric complex chronic conditions and other severe health ailments were predictive factors for entry into and persistence in the high-cost category. More than half of the total health expenditures were attributed to children in the top 10% expenditure group. In addition, risk protection and healthcare insurance support for high-cost children was found to be inadequate, particularly for children from low-income families.
Conclusions:
Healthcare support for children impacts individual development and family financial status. This study described the characteristics and spending patterns of children patients in the largest developing country. The fact that over half of total expenditures are concentrated toward 10% of patients makes it valuable to consider relevant support for this group, especially for families whose medical costs are higher than income.
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