One of the growing strategies in our attempt to reduce health care costs at a population level is to focus our attention on those children who are a small percentage of those hospitalized but are in the top 10% of highest healthcare costs for their hospitalizations. Peltz et al. (10.1542/peds.2015-1829) opted to better define this high cost population by looking at hospitalization trends for those with the highest inpatient annual costs and then follow these children in subsequent years. The authors looked at more than 265,000 children between ages 2 to 15 with more than one admission in a year to 39 children’s hospitals in the Pediatric Health Information System (PHIS). 10% of these hospitalized patients were identified as having the highest costs and then continued to be followed in subsequent years to see if that trend continued.
The sad news is that these 10% were responsible for almost 60% of total inpatient costs in this study with many having respiratory chronic conditions, and needing technology assistance. The good news is that after the index year, the majority of the children studied did not seem to continue to run up hospitalization charges in subsequent years. The authors do their best from their large data set to give us hints as to which risk factors do indicate persistent high cost hospitalizations and which may point to this being a one year only phenomenon.
If you are as focused on trying to enhance the quality of your care while decreasing costs of hospitalization, then this article may provide some useful information in your quest to target cost-reducing measures even more carefully than ever before. See what we mean by reading this topical study.
