Vikas Goyal1,2,3, Steven M McPhail4,5, Frank Hurley6, Keith Grimwood7,8,9, Julie M Marchant1,3, I Brent Masters1,2, Anne B Chang1,3,10. 1. Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, Brisbane, QLD, Australia. 2. Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia. 3. Centre for Children's Health Research, Queensland University of Technology, Brisbane, QLD, Australia. 4. Australian Centre for Health Services Innovation and School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia. 5. Clinical Informatics, Metro South Health, Brisbane, QLD, Australia. 6. Department of Finance, Queensland Children's Hospital, Brisbane, QLD, Australia. 7. School of Medicine and Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia. 8. Department of Infectious Diseases, Gold Coast Health, Gold Coast, QLD, Australia. 9. Department of Paediatrics, Gold Coast Health, Gold Coast, QLD, Australia. 10. Child Health Division, Menzies School of Health Research, Darwin, NT, Australia.
Abstract
BACKGROUND AND OBJECTIVE: Despite paediatric bronchiectasis being recognized increasingly worldwide, prior reports of hospitalization costs for bronchiectasis in children are lacking. This study aimed to (i) identify health service costs of hospitalizations and (ii) factors associated with these costs in children admitted to an Australian paediatric hospital following an acute exacerbation of their bronchiectasis. METHODS: Demographic and hospital resource use data were prospectively recorded for 100 hospitalizations in 80 children aged <18 years admitted consecutively to the QCH, Brisbane, Australia. Costs (2016 AUD) were obtained from the hospital's Finance Department. Linear regressions, with bootstrap resampling to quantify uncertainty, were used to estimate factors affecting cost of hospitalization. RESULTS: The 100 hospitalizations (48 males) had a median (IQR) age of 6.04 (4.04-9.85) years. Their mean (SD) LOS was 12.30 (4.60) days. The mean (SD) direct health service cost was AUD 30 182 (13 998) per hospitalization. The greatest contributor to costs was health professional wages, accounting for 70% of the cost per episode. LOS, younger age at admission and number of bronchiectatic lobes affected were associated with higher costs, whilst HITH service was associated with lower cost. The cost to families on average was AUD 2669.50 (SD: 991.50) per hospitalization when accounting for lost wages and opportunity cost. CONCLUSION: The per episode healthcare cost burden of hospitalizations for paediatric bronchiectasis exacerbations is substantial. Interventions that prevent hospitalized exacerbations and reduce severity of childhood bronchiectasis with even moderate effectiveness are likely to result in substantial hospital costs savings.
BACKGROUND AND OBJECTIVE: Despite paediatric bronchiectasis being recognized increasingly worldwide, prior reports of hospitalization costs for bronchiectasis in children are lacking. This study aimed to (i) identify health service costs of hospitalizations and (ii) factors associated with these costs in children admitted to an Australian paediatric hospital following an acute exacerbation of their bronchiectasis. METHODS: Demographic and hospital resource use data were prospectively recorded for 100 hospitalizations in 80 children aged <18 years admitted consecutively to the QCH, Brisbane, Australia. Costs (2016 AUD) were obtained from the hospital's Finance Department. Linear regressions, with bootstrap resampling to quantify uncertainty, were used to estimate factors affecting cost of hospitalization. RESULTS: The 100 hospitalizations (48 males) had a median (IQR) age of 6.04 (4.04-9.85) years. Their mean (SD) LOS was 12.30 (4.60) days. The mean (SD) direct health service cost was AUD 30 182 (13 998) per hospitalization. The greatest contributor to costs was health professional wages, accounting for 70% of the cost per episode. LOS, younger age at admission and number of bronchiectatic lobes affected were associated with higher costs, whilst HITH service was associated with lower cost. The cost to families on average was AUD 2669.50 (SD: 991.50) per hospitalization when accounting for lost wages and opportunity cost. CONCLUSION: The per episode healthcare cost burden of hospitalizations for paediatric bronchiectasis exacerbations is substantial. Interventions that prevent hospitalized exacerbations and reduce severity of childhood bronchiectasis with even moderate effectiveness are likely to result in substantial hospital costs savings.
Authors: Anne B Chang; Lucy C Morgan; Emma L Duncan; Mark D Chatfield; André Schultz; Paul J Leo; Gabrielle B McCallum; Aideen M McInerney-Leo; Steven M McPhail; Yuejen Zhao; Catherine Kruljac; Heidi C Smith-Vaughan; Peter S Morris; Julie M Marchant; Stephanie T Yerkovich; Anne L Cook; Danielle Wurzel; Lesley Versteegh; Hannah O'Farrell; Margaret S McElrea; Sabine Fletcher; Heather D'Antoine; Enna Stroil-Salama; Phil J Robinson; Keith Grimwood Journal: BMJ Open Respir Res Date: 2022-05
Authors: Julie M Marchant; Anne B Chang; Kobi L Schutz; Lesley Versteegh; Anne Cook; Jack Roberts; Peter S Morris; Stephanie T Yerkovich; Gabrielle B McCallum Journal: BMJ Open Date: 2021-12-22 Impact factor: 2.692
Authors: Anne B Chang; Jeanette Boyd; Leanne Bell; Vikas Goyal; I Brent Masters; Zena Powell; Christine Wilson; Angela Zacharasiewicz; Efthymia Alexopoulou; Andrew Bush; James D Chalmers; Rebecca Fortescue; Adam T Hill; Bulent Karadag; Fabio Midulla; Gabrielle B McCallum; Deborah Snijders; Woo-Jung Song; Thomy Tonia; Keith Grimwood; Ahmad Kantar Journal: ERJ Open Res Date: 2021-07-19
Authors: Julie M Marchant; Anne L Cook; Jack Roberts; Stephanie T Yerkovich; Vikas Goyal; Daniel Arnold; Hannah E O'Farrell; Anne B Chang Journal: J Clin Med Date: 2021-12-14 Impact factor: 4.241