Health Care Use and Spending of Pediatric Patients With an Intellectual or Developmental Disability.
Ambulatory Care
/ economics
Case-Control Studies
Child
Developmental Disabilities
/ economics
Emergency Service, Hospital
/ economics
Female
Health Expenditures
/ statistics & numerical data
Health Surveys
Home Care Services
/ economics
Hospitalization
/ economics
Humans
Intellectual Disability
/ economics
Male
United States
/ epidemiology
Journal
Medical care
ISSN: 1537-1948
Titre abrégé: Med Care
Pays: United States
ID NLM: 0230027
Informations de publication
Date de publication:
05 2020
05 2020
Historique:
pubmed:
15
1
2020
medline:
6
5
2020
entrez:
15
1
2020
Statut:
ppublish
Résumé
Health care costs and utilization for those with an intellectual or developmental disability (IDD) have been shown to be higher than the general population. To investigate the services that contribute to higher costs and utilization among noninstitutionalized children with an IDD. Matched case-control secondary analysis of the 2000-2017 Medical Expenditure Panel Survey. Pediatric (age 0-21) patients with an IDD were matched to non-IDD subjects. Health care utilization and costs were evaluated with zero-inflated negative binomial regressions and generalized linear models, respectively. Outcome measures included high-acuity health care utilization [ie, emergency department (ED) visits and hospital admissions], and cost outcomes for total spending, ED use, hospitalization, medications, office visits, home health, and physical therapy. There was no statistical difference in utilization of EDs among the 2 groups though subjects with an IDD showed more hospitalizations than their matched cohort (incidence rate ratios=1.63, P=0.00). Total health care spending was higher among patients with an IDD (coefficient=$5831, P=0.00). Pediatric spending was higher in all measures except for ED. The biggest discrepancies in spending were seen in home health (coefficient=$2558, P=0.00) and outpatient visits (coefficient=$1180, P=0.00). Pediatric patients with an IDD had higher health care spending and utilization than non-IDD subjects in all categories except for ED use.
Sections du résumé
BACKGROUND
Health care costs and utilization for those with an intellectual or developmental disability (IDD) have been shown to be higher than the general population.
OBJECTIVE
To investigate the services that contribute to higher costs and utilization among noninstitutionalized children with an IDD.
DESIGN
Matched case-control secondary analysis of the 2000-2017 Medical Expenditure Panel Survey. Pediatric (age 0-21) patients with an IDD were matched to non-IDD subjects. Health care utilization and costs were evaluated with zero-inflated negative binomial regressions and generalized linear models, respectively.
MEASURES
Outcome measures included high-acuity health care utilization [ie, emergency department (ED) visits and hospital admissions], and cost outcomes for total spending, ED use, hospitalization, medications, office visits, home health, and physical therapy.
RESULTS
There was no statistical difference in utilization of EDs among the 2 groups though subjects with an IDD showed more hospitalizations than their matched cohort (incidence rate ratios=1.63, P=0.00). Total health care spending was higher among patients with an IDD (coefficient=$5831, P=0.00). Pediatric spending was higher in all measures except for ED. The biggest discrepancies in spending were seen in home health (coefficient=$2558, P=0.00) and outpatient visits (coefficient=$1180, P=0.00).
CONCLUSIONS
Pediatric patients with an IDD had higher health care spending and utilization than non-IDD subjects in all categories except for ED use.
Identifiants
pubmed: 31934953
doi: 10.1097/MLR.0000000000001293
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM