Assessing differences among persistent, episodic, and non- high-need high-cost hospitalized children in China after...

Area of Science:

• Pediatric Healthcare
• Health Economics
• Data Science in Medicine

Background:

• High-need, high-cost (HNHC) patients are a key focus in global healthcare reform.
• Research on HNHC pediatric populations in China is limited, necessitating further investigation.
• Understanding HNHC patient profiles is crucial for effective resource allocation and policy development.

Purpose of the Study:

• To classify high-need, high-cost (HNHC) pediatric patients in China.
• To analyze the distinct characteristics and healthcare utilization patterns among different HNHC patient groups.
• To identify key factors influencing the HNHC status in hospitalized children.

Main Methods:

• Retrospective observational cohort study of 688,131 hospitalized children in Shanghai (2017-2023).
• K-means clustering algorithm used for patient classification based on HNHC status.
• Descriptive statistics, Kruskal-Wallis H test, and logit regression models employed for analysis.

Main Results:

• Three patient groups identified: persistent HNHC (1,871), episodic HNHC (32,539), and non-HNHC (653,721).
• Persistent HNHC patients exhibited significantly higher costs and longer HNHC durations.
• Distinct healthcare utilization patterns observed, including higher emergency admissions, surgery rates, and longer hospital stays, with leukemia being a prevalent and costly condition.

Conclusions:

• This study offers critical insights into the classification and factors influencing HNHC pediatric patients in China.
• Persistent HNHC patients require tailored interventions to optimize health outcomes and reduce healthcare expenditures.
• Recommendations include enhanced medical coverage, specialized healthcare services, and early intervention strategies.