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Pediatric Neuroinflammatory Disorders: Patterns of Hospital Utilization and Population Burden
Alexander J Sandweiss1, Chau Truong2, Kristy O Murray3
1Department of Pediatrics, Division of Pediatric Neurology and Developmental Neuroscience, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas.
Insights
Pediatric neuroinflammatory disorders (NIDs) lead to costly hospitalizations, often requiring intensive care and longer stays. Understanding this burden is crucial for healthcare resource allocation and patient management.
Area of Science:
- Pediatric Neurology
- Health Economics
- Healthcare Management
Background:
- Pediatric neuroinflammatory disorders (NIDs) represent a significant, yet under-quantified, healthcare burden.
- Existing data lacks comprehensive cost estimates for NID-related hospitalizations in children.
- These conditions are suspected to disproportionately impact healthcare expenditures.
Purpose of the Study:
- To assess the economic and resource utilization burden of pediatric hospitalizations for NIDs.
- To identify key drivers of inpatient resource use in pediatric NID cases.
- To analyze cost, length of stay, and intensive care unit (ICU) utilization.
Main Methods:
- Analysis of Texas hospital administrative data (2016-2023).
- Inclusion of pediatric hospitalizations for specific NIDs: acute disseminated encephalomyelitis, encephalitis/encephalomyelitis (E/EM), multiple sclerosis/neuromyelitis optica spectrum disorders, other demyelinating disorders, acute transverse myelitis, and other myelitis.
- Conversion of charges to costs using hospital-specific cost-to-charge ratios, inflated to 2023 values; statistical modeling for high-cost, long-LOS, and ICU admissions.
Main Results:
- A total of 2155 pediatric NID hospitalizations were identified, with E/EM being the most frequent diagnosis.
- Median hospitalization cost was $31,365.49, with a median length of stay (LOS) of 6 days.
- Over half (59.1%) of hospitalizations involved ICU admission, significantly increasing costs; diagnostic group predicted high-cost, long-LOS, and ICU stays.
Conclusions:
- Pediatric NIDs impose a substantial healthcare burden, characterized by prolonged hospital stays, intensive care needs, and elevated costs.
- Findings confirm clinical observations regarding the resource-intensive nature of these conditions.
- The study underscores the need for better understanding and management of NIDs in pediatric populations.
Background And Objectives:
Pediatric neuroinflammatory disorders (NIDs) pose significant health and financial challenges, yet comprehensive cost estimates are lacking. These conditions likely contribute disproportionately to health care expenditures. To assess the burden of NID-related hospitalizations, we analyzed Texas hospital administrative records.
Methods:
We used the Texas Health Care Information Collection Inpatient Public Use Data File (2016-2023) to explore drivers of inpatient resource use for NIDs. Pediatric hospitalizations with a primary diagnosis of acute disseminated encephalomyelitis, encephalitis and encephalomyelitis (E/EM), multiple sclerosis/neuromyelitis optica spectrum disorders, and other demyelinating disorders, or acute transverse myelitis and other myelitis were included. Charges were converted to costs using hospital-level annual average cost-to-charge ratios and then inflated to 2023 costs. Statistical analysis was implemented to predict the likelihood of having a high-cost or a longer length of stay (LOS) hospitalization and a hospitalization that involved intensive care.
Results:
There were 2155 hospitalizations involving pediatric patients with a primary diagnosis of NIDs. The most common diagnoses were E/EM. The median total cost of these hospitalizations was $31 365.49, with a median LOS of 6 days. More than half (59.1%) required intensive care unit (ICU) admission and were associated with a higher cost. After adjusting for patient and facility characteristics, the primary diagnostic group remained a significant independent predictor of whether hospitalization was classified as high-cost or long-LOS or involved an ICU stay.
Conclusions:
These findings align with clinical observations, highlighting the significant burden of NIDs, which often require longer hospital stays, intensive care, and higher costs compared with most pediatric conditions.
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