Characteristics and related factors of high-need high-cost children in Shanghai, China: a retrospective cohort study in inpatient setting
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View abstract on PubMed
Summary
This summary is machine-generated.High-need high-cost pediatric patients in China represent a significant healthcare burden. Identifying their characteristics and associated factors is crucial for improving care and resource allocation.
Area Of Science
- Pediatric healthcare economics
- Health services research
- Public health policy
Background
- High-need high-cost (HNHC) pediatric patients incur substantial healthcare expenses and face adverse health outcomes.
- Limited research exists on the specific characteristics and determinants of HNHC pediatric patients in China.
- Understanding these factors is vital for developing targeted interventions and resource allocation strategies.
Purpose Of The Study
- To characterize high-need high-cost (HNHC) pediatric patients in Shanghai, China.
- To identify patient, healthcare utilization, and hospital factors associated with HNHC status in hospitalized children.
Main Methods
- Retrospective cohort study analyzing claims data from 2017-2023 in Shanghai.
- Defined HNHC patients as the top 5% by annual standardized cost.
- Utilized descriptive statistics, Mann-Whitney U test, and a generalized linear model to identify associated factors.
Main Results
- HNHC pediatric patients (34,410) differed significantly from non-HNHC patients (653,721) in age, insurance, admission type, procedures, and hospital stay duration.
- HNHC patients consistently accounted for over 35% of total annual healthcare expenditures.
- Key factors associated with HNHC status included younger/older age, single insurance, emergency/transferred admissions, surgery, longer stays, and hospital characteristics (tertiary, suburban, non-specialized).
Conclusions
- Findings highlight the need for expanded medical coverage and financial risk protection for pediatric patients in China.
- Recommendations include addressing HNHC-related diseases and optimizing pediatric medical resource allocation within the healthcare system.
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