You are here

Report: Pediatric Asthma Costs Vary Widely Across Hospitals

Authors find significant differences in ICU use and length of stay

In an analysis of practice patterns at 37 major nonprofit U.S. children’s hospitals, researchers have found that intensive care unit (ICU) usage was 254% higher for asthma patients when comparing the lower eighth to the upper eighth of hospitals. The retrospective study was conducted by the Children’s Hospital of Philadelphia and the University of Pennsylvania’s Perelman School of Medicine.

Using three years of data from 48,887 children, the researchers constructed an asthma template consisting of representative children hospitalized for asthma between April 1, 2011, and March 31, 2014. Despite similar characteristics of the patients, the authors observed large and significant variation in the use of ICUs as well as in length of stay and cost.

“As the most prevalent chronic illness in children, asthma imposes a major financial burden on many health care systems,” said study leader Jeffrey H. Silber, MD, PhD.

For the same template-matched populations, the investigators found that the median per-patient cost of asthma care varied by 87% ($3,157 vs. $5,912; P < 0.001) between the lower eighth and the upper eighth of hospitals. In addition, total hospital length of stay varied by 47% (1.5 days vs. 2.2 days; P < .001), and ICU utilization was 254% higher (6.5% vs. 23.0%; P < 0.001).

Moreover, the patterns of resource utilization by patient risk differed significantly across hospitals. For example, as patient risk increased, one hospital showed significantly increasing costs compared with matched controls (comparative cost difference: lowest risk, −34.2%; highest risk, +53.3%; P < 0.001). In contrast, another hospital displayed significantly decreasing costs relative to its matched controls as patient risk increased (comparative cost difference: lowest risk, −10.1%; highest risk, −16.9%; P = 0.01).

“If hospitals can better understand if their care practices are disproportionately expensive and inefficient compared to other hospitals, they may be better able to pinpoint opportunities for quality improvements,” Silber said.

The study was published in JAMA Pediatrics.

Sources: HealthLeaders Media; July 19, 2016; and JAMA Pediatrics; July 11, 2016.

Recent Headlines

Scenesse is new treatment for people with rare, painful light sensitivity disease
Humira, Rituxan top list of drugs that added $5.1 billion to nation's health care bill
Lower court rulings cleared the way for generic versions of the MS drug
Maryland man wins lawsuit that alleges that the company's antipsychotic caused his gynecomastia
Antidepressants, ADHD meds are also used to self-poison
Study lists steps that could save close to $300 billion a year
While many victims used THC, the cause remains elusive
Descovy joins Truvada, another Gilead product, in the HIV prophylaxis market
Data show PTC Therapeutics drug preserves lung function