Determinants of Health Care Use in a Population-Based Leukodystrophy Cohort - 26/02/13
Reprint requests: Joshua L. Bonkowsky, MD, PhD, Division of Pediatric Neurology, Department of Pediatrics, University of Utah Health Sciences Center, 295 Chipeta Way/Williams Building, Salt Lake City, UT 84108.Abstract |
Objectives |
To determine the costs for children with leukodystrophies and whether high costs are associated with characteristic clinical features or resources use.
Study design |
We determined health care costs in a population cohort of 122 patients with leukodystrophies, including inpatient, outpatient, and emergency department use, during a 9-year period. We analyzed differences in patients with high costs (>85th percentile) and their health care use.
Results |
Patients with leukodystrophy had significant variability in resource use, with the top 15th percentile of patients accounting for 73% of costs ($9.6 million). The majority of costs, 81% ($10.8 million), arose from inpatient hospitalization. High-cost patients had more and longer hospitalizations, increased requirements for intensive unit care and mechanical ventilation, and significantly more infections. Importantly, bone marrow transplantation did not solely account for the difference between high-cost and low-cost groups.
Conclusion |
Inpatient hospitalization is the greatest source of health care resource use in patients with leukodystrophies. A minority of patients account for the majority of costs, primarily attributable to an increased volume of hospitalization. Strategies to improve care and reduce costs will need to reduce inpatient stays and target modifiable reasons for hospitalization.
Le texte complet de cet article est disponible en PDF.Keyword : EDW, ICU, IH, MLD
Plan
| R.S. was funded in part by the National Institutes of Health (NIH; K23 HD052553), from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and has received research support from the Primary Children’s Medical Center Foundation. J.B. is funded by NIH (K08 DA024753), from the National Institute on Drug Abuse, and has received research support from the Primary Children’s Medical Center Foundation. The authors declare no conflicts of interest. |
Vol 162 - N° 3
P. 624 - mars 2013 Retour au numéro
Article précédent
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