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Disability, Hospital Care, and Cost: Utilization of Emergency and Inpatient Care by a Cohort of Children with Intellectual and Developmental Disabilities
Journal article   Peer reviewed

Disability, Hospital Care, and Cost: Utilization of Emergency and Inpatient Care by a Cohort of Children with Intellectual and Developmental Disabilities

Scott Lindgren, Emily Lauer, Elizabeth Momany, Tara Cope, Julie Royer, Lindsay Cogan, Suzanne McDermott and Brian S Armour
The Journal of pediatrics, Vol.229, pp.259-266
02/2021
DOI: 10.1016/j.jpeds.2020.08.084
PMCID: PMC7885996
PMID: 32890584
url
https://www.ncbi.nlm.nih.gov/pmc/articles/7885996View
Open Access

Abstract

To use medical claims data to determine patterns of healthcare utilization in children with intellectual and developmental disabilities, including frequency of service utilization, conditions that require hospital care, and costs. Medicaid administrative claims from 4 states (Iowa, Massachusetts, New York, and South Carolina) from years 2008-2013 were analyzed, including 108 789 children (75 417 male; 33 372 female) under age 18 years with intellectual and developmental disabilities. Diagnoses included cerebral palsy, autism, fetal alcohol syndrome, Down syndrome/trisomy/autosomal deletions, other genetic conditions, and intellectual disability. Utilization of emergency department (ED) and inpatient hospital services were analyzed for 2012. Children with intellectual and developmental disabilities used both inpatient and ED care at 1.8 times that of the general population. Epilepsy/convulsions was the most frequent reason for hospitalization at 20 times the relative risk of the general population. Other frequent diagnoses requiring hospitalization were mood disorders, pneumonia, paralysis, and asthma. Annual per capita expenses for hospitalization and ED care were 100% higher for children with intellectual and developmental disabilities, compared with the general population ($153 348 562 and $76 654 361, respectively). Children with intellectual and developmental disabilities utilize significantly more ED and inpatient care than other children, which results in higher annual costs. Recognizing chronic conditions that increase risk for hospital care can provide guidance for developing outpatient care strategies that anticipate common clinical problems in intellectual and developmental disabilities and ensure responsive management before hospital care is needed.
Adolescent Child Child, Preschool Developmental Disabilities - economics Developmental Disabilities - therapy Emergency Service, Hospital - economics Emergency Service, Hospital - statistics & numerical data Facilities and Services Utilization - economics Facilities and Services Utilization - statistics & numerical data Female Health Care Costs Hospitalization - economics Hospitalization - statistics & numerical data Humans Infant Intellectual Disability - economics Intellectual Disability - therapy Iowa Male Massachusetts New York South Carolina

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