Mark R Zonfrillo1, Isabella Zaniletti2, Matthew Hall3, Evan S Fieldston4, Jeffrey D Colvin5, Jessica L Bettenhausen5, Michelle L Macy6, Elizabeth R Alpern7, Gretchen J Cutler8, Jean L Raphael9, Rustin B Morse10, Marion R Sills11, Samir S Shah12. 1. 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. 2. Department of Statistics, University of Missouri, Columbia, MO. 3. Children's Hospital Association, Overland Park, KS. 4. Alpert Medical School of Brown University, Providence, RI; Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA. 5. Department of Pediatrics, Children's Mercy Hospitals and Clinics, University of Missouri-Kansas City School of Medicine, Kansas City, MO. 6. 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. 7. Department of Pediatrics, Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL. 8. Department of Pediatric Emergency Medicine, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN. 9. Department of Pediatrics, Section on Academic General Pediatrics, Baylor College of Medicine, Houston, TX. 10. Children's Health System of Texas, Dallas, TX. 11. Children's Hospital Colorado, Aurora, CO. 12. Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH.
Abstract
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.
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.
Authors: Michel B Aboutanos; Anne Jordan; Robert Cohen; Robin L Foster; Kimberly Goodman; Raquel W Halfond; Rachel Poindexter; Rashel Charles; Stephanie C Smith; Luke G Wolfe; Bonita Hogue; Rao R Ivatury Journal: J Trauma Date: 2011-07
Authors: Adil H Haider; Paul Logan Weygandt; Jessica M Bentley; Maria Francesca Monn; Karim Abdur Rehman; Benjamin L Zarzaur; Marie L Crandall; Edward E Cornwell; Lisa A Cooper Journal: J Trauma Acute Care Surg Date: 2013-05 Impact factor: 3.313
Authors: Laura D Cassidy; Daphne Lambropoulos; Jessica Enters; David Gourlay; Mina Farahzad; Dave R Lal Journal: J Am Coll Surg Date: 2013-05-08 Impact factor: 6.113
Authors: Laurent G Glance; Turner M Osler; Dana B Mukamel; J Wayne Meredith; Yue Li; Feng Qian; Andrew W Dick Journal: Health Serv Res Date: 2013-05-13 Impact factor: 3.402
Authors: James Booker; Samuel Hall; Alexander Dando; Christopher Dare; Evan Davies; Stephen McGillion; Nijaguna Mathad; Ryan Waters; Vassilios Tsitouras; Nilesh Mundil; Salima Wahab; Aabir Chakraborty Journal: Childs Nerv Syst Date: 2021-01-29 Impact factor: 1.475