Gupta Ruchi S, Bewtra Meenakshi, Prosser Lisa A, Finkelstein Jonathan A
Harvard Pediatric Health Services Research Fellowship, Children's Hospital Boston, Massachusetts, USA.
Ambul Pediatr. 2006 Jan-Feb;6(1):15-20. doi: 10.1016/j.ambp.2005.07.001.
To examine patient and hospital characteristics associated with varying hospital charges for children admitted with asthma.
We conducted a retrospective cohort study of children (1-18 years old) hospitalized with asthma using data from the 2000 Kids' Inpatient Database (KID; n = 54,029). Predictors of interest included hospital type (teaching and children's hospitals) and patient characteristics (insurance type and race).
After adjusting for patient and hospital characteristics, hospital charges were similar at teaching and nonteaching hospitals. Charges at children's hospitals were higher by 440 US dollars or 10% (95% CI, 352-528) compared with nonchildren's hospitals. Children with Medicaid had higher charges by 132 US dollars or 3% (95% CI, 57-264) compared to those with private insurance. Compared to White children, Black children had higher charges by 396 US dollars or 10% (95% CI, 352-484), Hispanic children by 924 US dollars or 21% (95% CI, 880-1,012), and Asian children by 572 US dollars or 13% (572 US dollars; 95% CI, 352-792).
Important differences exist in the charges incurred by children with asthma based on patient and hospital characteristics. Efforts to understand the reasons behind the differences may help eliminate unnecessary variation in costs for asthma care.
研究与哮喘住院儿童不同医院收费相关的患者及医院特征。
我们利用2000年儿童住院数据库（KID；n = 54,029）的数据，对因哮喘住院的1至18岁儿童进行了一项回顾性队列研究。感兴趣的预测因素包括医院类型（教学医院和儿童医院）及患者特征（保险类型和种族）。
在对患者和医院特征进行调整后，教学医院和非教学医院的收费相似。与非儿童医院相比，儿童医院的收费高出440美元或10%（95%CI，352 - 528）。与有私人保险的儿童相比，医疗补助儿童的收费高出132美元或3%（95%CI，57 - 264）。与白人儿童相比，黑人儿童的收费高出396美元或10%（95%CI，352 - 484），西班牙裔儿童高出924美元或21%（95%CI，880 - 1,012），亚裔儿童高出572美元或13%（572美元；95%CI，352 - 792）。
基于患者和医院特征，哮喘儿童的费用存在重要差异。了解这些差异背后的原因的努力可能有助于消除哮喘护理费用中不必要的差异。
