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Payer and race/ethnicity influence length and cost of childhood cancer hospitalizations.
Whittle, Sarah B; Lopez, Michelle A; Russell, Heidi V.
Afiliação
  • Whittle SB; Texas Children's Cancer and Hematology Centers, Texas Children's Hospital, Houston, Texas.
  • Lopez MA; Department of Pediatrics, Baylor College of Medicine, Houston, Texas.
  • Russell HV; Department of Pediatrics, Baylor College of Medicine, Houston, Texas.
Pediatr Blood Cancer ; 66(7): e27739, 2019 07.
Article em En | MEDLINE | ID: mdl-30989762
BACKGROUND: Health disparities related to race, ethnicity, socioeconomic status, and insurance status impact quality, access, and health outcomes for children. Medicaid is a proxy for poverty and restricted access to health care. The goal of this study was to determine if there are discrepancies in the length and cost of hospitalizations between admissions covered by Medicaid or commercial insurance for pediatric patients with cancer. METHODS: Childhood cancer-related admissions were identified from the 2012 Kids Inpatient Database (KID) using the International Classification of Diseases, Ninth revision. Length of hospitalization and cost of hospitalization were compared among hospitalizations paid by Medicaid or commercial insurance. Total admission charges were converted to costs using cost-to-charge ratios, and survey weighting methods were used for all analyses. Linear multiple regression models for both length of hospitalization and cost were developed to include patient-level factors (race, sex, age, diagnosis, reason for admission). RESULTS: In 2012, there were 104 597 childhood cancer-related admissions. Hospitalizations paid by Medicaid were significantly longer than those paid by commercial insurance. Hispanic ethnicity was associated with higher cost of hospitalization regardless of payer, and black race was associated with higher costs within the Medicaid population. CONCLUSIONS: This analysis identifies differences in healthcare utilization for pediatric cancer-related admissions paid for by Medicaid compared with commercial insurance. Prolonged hospitalizations and increased costs create burdens on children and their families, medical delivery systems, and third-party payers. Further exploration into the causes of these disparities is warranted.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Hispânico ou Latino / Aceitação pelo Paciente de Cuidados de Saúde / Medicaid / Custos de Cuidados de Saúde / Tempo de Internação / Neoplasias Tipo de estudo: Health_economic_evaluation / Prognostic_studies Limite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male País como assunto: America do norte Idioma: En Ano de publicação: 2019 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Hispânico ou Latino / Aceitação pelo Paciente de Cuidados de Saúde / Medicaid / Custos de Cuidados de Saúde / Tempo de Internação / Neoplasias Tipo de estudo: Health_economic_evaluation / Prognostic_studies Limite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male País como assunto: America do norte Idioma: En Ano de publicação: 2019 Tipo de documento: Article