David A Sclar1, Linda M Robison, Corrine Gavrun, Tracy L Skaer. 1. Pharmacoeconomics and Pharmacoepidemiology Research Unit, Department of Health Policy and Administration, Washington State University, P.O. Box 646510, Pullman, WA 99164-6510, USA. sclar@mail.wsu.edu <sclar@mail.wsu.edu>
Abstract
OBJECTIVE: This study aimed (a) to discern the distribution by primary payer (public vs. private) of U.S. patients aged 5-18 years who were hospitalized with a primary diagnosis of depression and (b) to discern the mean hospital length of stay and mean charge per day by payer type. METHODS: The 2003 Healthcare Cost and Utilization Project Kids' Inpatient Database was used for this analysis. Depression was defined as International Classification of Diseases, 9th Revision, Clinical Modification codes 296.2-296.36, 300.4 or 311. Differences in hospital length of stay and mean cost per day by payer type were discerned via adjusted least square mean analysis (+/-S.E.). RESULTS: The adjusted mean hospital length of stay was significantly higher (P<.0001) for patients with a public payer (6.6+/-0.05 days) versus a private payer (5.3+/-0.05 days). Although statistically significant (P<.0001), the adjusted mean charge per day differed little by payer type (public, US$1316.39+/-9.82; private, US$1357.51+/-9.07). CONCLUSIONS: Further research is required to discern whether observed differences in hospital length of stay are the result of private payers enhancing patient care, thereby discharging patients in a more efficient manner, or the patients being discharged prematurely from the hospital due to constraints in reimbursement by private payers.
OBJECTIVE: This study aimed (a) to discern the distribution by primary payer (public vs. private) of U.S. patients aged 5-18 years who were hospitalized with a primary diagnosis of depression and (b) to discern the mean hospital length of stay and mean charge per day by payer type. METHODS: The 2003 Healthcare Cost and Utilization Project Kids' Inpatient Database was used for this analysis. Depression was defined as International Classification of Diseases, 9th Revision, Clinical Modification codes 296.2-296.36, 300.4 or 311. Differences in hospital length of stay and mean cost per day by payer type were discerned via adjusted least square mean analysis (+/-S.E.). RESULTS: The adjusted mean hospital length of stay was significantly higher (P<.0001) for patients with a public payer (6.6+/-0.05 days) versus a private payer (5.3+/-0.05 days). Although statistically significant (P<.0001), the adjusted mean charge per day differed little by payer type (public, US$1316.39+/-9.82; private, US$1357.51+/-9.07). CONCLUSIONS: Further research is required to discern whether observed differences in hospital length of stay are the result of private payers enhancing patient care, thereby discharging patients in a more efficient manner, or the patients being discharged prematurely from the hospital due to constraints in reimbursement by private payers.
Authors: Matthew L Stone; Damien J LaPar; Daniel P Mulloy; Sara K Rasmussen; Bartholomew J Kane; Eugene D McGahren; Bradley M Rodgers Journal: J Pediatr Surg Date: 2013-01 Impact factor: 2.545