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Use of health services by chronically ill and disabled children
Insights
Children with chronic conditions, including cystic fibrosis and cerebral palsy, utilize 10 times more health services than healthy peers. A small group accounts for most hospital and outpatient care, with costs 10x higher.
Area of Science:
- Pediatric Healthcare
- Health Services Research
- Chronic Illness Management
Background:
- Children with chronic conditions often require extensive healthcare services.
- Understanding the utilization patterns and costs associated with pediatric chronic illness is crucial for resource allocation and policy development.
Purpose of the Study:
- To examine and compare hospitalization and outpatient healthcare service utilization between chronically ill/disabled children and a healthy comparison group.
- To identify factors influencing healthcare use and expenditure among pediatric patients with chronic conditions.
Main Methods:
- A comparative study involving 369 pediatric patients with cystic fibrosis, cerebral palsy, myelodysplasia, or multiple physical handicaps.
- Comparison with 456 randomly selected children without congenital conditions from the Cleveland area.
- Analysis of hospitalization and outpatient service utilization and estimated expenditures over a 1-year period.
Main Results:
- Chronically ill or disabled children used 10 times more hospitalization and outpatient services than comparison children.
- Physician specialists, occupational/physical therapists, and school nurses were disproportionately used by the chronically ill/disabled group.
- A small subset of children accounted for a significant majority of all hospital and outpatient care, with estimated expenditures 10 times higher for the chronically ill/disabled sample.
Conclusions:
- Children with chronic conditions represent a high-need population with significantly greater healthcare utilization and expenditure.
- Healthcare resource allocation must consider the disproportionate needs of a small subset of chronically ill children.
- Outpatient care patterns vary based on diagnosis, functional impairment, race, and income, necessitating tailored healthcare approaches.
Abstract:
Hospitalization and use of outpatient health care services during a 1-year period by 369 pediatric patients with cystic fibrosis, cerebral palsy, myelodysplasia, or multiple physical handicaps and 456 randomly selected children without congenital conditions from the Cleveland area were examined. Use of hospitalization and outpatient services by the average chronically ill or disabled child was 10 times that of the average comparison child. Physician specialists, occupational and physical therapists, and school nurses were the major outpatient categories used disproportionately by children with chronic illnesses or disabilities. The major share of health care used by children with chronic conditions was attributable to a small subset of children: All hospital care was accounted for by one third of the children, and three quarters of all outpatient care was accounted for by one quarter of that sample. Hospital care was used at similar rates by the four diagnostic groups. However, amount and type of outpatient care varied by diagnosis, level of functional impairment, race, and income. Estimated average expenditure for health services used by the chronically ill or disabled sample was 10 times that of the comparison sample. Relative distribution of estimated expenditures across types of services differed for the two samples as well as among diagnostic categories.