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Socioeconomic Status and Hospitalization Costs for Children with Brain and Spinal Cord Injury.
Zonfrillo, Mark R; Zaniletti, Isabella; Hall, Matthew; Fieldston, Evan S; Colvin, Jeffrey D; Bettenhausen, Jessica L; Macy, Michelle L; Alpern, Elizabeth R; Cutler, Gretchen J; Raphael, Jean L; Morse, Rustin B; Sills, Marion R; Shah, Samir S.
Afiliação
  • Zonfrillo MR; Department of Emergency Medicine and Injury Prevention Center, Hasbro Children's Hospital, Providence, RI; Alpert Medical School of Brown University, Providence, RI. Electronic address: zonfrillo@brown.edu.
  • Zaniletti I; Department of Statistics, University of Missouri, Columbia, MO.
  • Hall M; Children's Hospital Association, Overland Park, KS.
  • Fieldston ES; Alpert Medical School of Brown University, Providence, RI; Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA.
  • Colvin JD; Department of Pediatrics, Children's Mercy Hospitals and Clinics, University of Missouri-Kansas City School of Medicine, Kansas City, MO.
  • Bettenhausen JL; Department of Pediatrics, Children's Mercy Hospitals and Clinics, University of Missouri-Kansas City School of Medicine, Kansas City, MO.
  • Macy ML; Department of Emergency Medicine, Child Health Evaluation and Research Unit, Division of General Pediatrics, C.S. Mott Children's Hospital, University of Michigan Medical School, Ann Arbor, MI.
  • Alpern ER; Department of Pediatrics, Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL.
  • Cutler GJ; Department of Pediatric Emergency Medicine, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN.
  • Raphael JL; Department of Pediatrics, Section on Academic General Pediatrics, Baylor College of Medicine, Houston, TX.
  • Morse RB; Children's Health System of Texas, Dallas, TX.
  • Sills MR; Children's Hospital Colorado, Aurora, CO.
  • Shah SS; Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH.
J Pediatr ; 169: 250-5, 2016 Feb.
Article em En | MEDLINE | ID: mdl-26563534
OBJECTIVE: To determine if household income is associated with hospitalization costs for severe traumatic brain injury (TBI) and spinal cord injury (SCI). STUDY DESIGN: Retrospective cohort study of inpatient, nonrehabilitation hospitalizations at 43 freestanding children's hospitals for patients <19 years old with unintentional severe TBI and SCI from 2009-2012. Standardized cost of care for hospitalizations was modeled using mixed-effects methods, adjusting for age, sex, race/ethnicity, primary payer, presence of chronic medical condition, mechanism of injury, injury severity, distance from residence to hospital, and trauma center level. Main exposure was zip code level median annual household income. RESULTS: There were 1061 patients that met inclusion criteria, 833 with TBI only, 227 with SCI only, and 1 with TBI and SCI. Compared with those with the lowest-income zip codes, patients from the highest-income zip codes were more likely to be older, white (76.7% vs 50.4%), have private insurance (68.9% vs 27.9%), and live closer to the hospital (median distance 26.7 miles vs 81.2 miles). In adjusted models, there was no significant association between zip code level household income and hospitalization costs. CONCLUSIONS: Children hospitalized with unintentional, severe TBI and SCI showed no difference in standardized hospital costs relative to a patient's home zip code level median annual household income. The association between household income and hospitalization costs may vary by primary diagnosis.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Classe Social / Traumatismos da Medula Espinal / Lesões Encefálicas / Custos Hospitalares / Hospitalização / Hospitais Pediátricos Tipo de estudo: Etiology_studies / Health_economic_evaluation / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude Limite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male Idioma: En Revista: J Pediatr Ano de publicação: 2016 Tipo de documento: Article País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Classe Social / Traumatismos da Medula Espinal / Lesões Encefálicas / Custos Hospitalares / Hospitalização / Hospitais Pediátricos Tipo de estudo: Etiology_studies / Health_economic_evaluation / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude Limite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male Idioma: En Revista: J Pediatr Ano de publicação: 2016 Tipo de documento: Article País de publicação: Estados Unidos