Srivastava Rajendu, Downie James, Hall Jane, Reynolds Graham
University of Utah School of Medicine, Salt Lake City, Utah, USA.
Institute for Healthcare Leadership, Intermountain Healthcare, Salt Lake City, Utah, USA.
J Paediatr Child Health. 2016 May;52(5):566-71. doi: 10.1111/jpc.13152.
To describe the hospital costs, hospital types and differences across states and territories for children with medical complexity cared for in Australian public hospitals.
Retrospective national administrative database study of 212 Australian public hospitals from six states (excluding Queensland) and two territories that submitted cost data to the National Hospital Costing Data Collection for 2010-2011. Participants included all hospitalised patients with comparisons between adults and children (17 years of age and younger), and adults with chronic diseases and children with medical complexity. Total hospital costs were the main outcome measure.
The National Hospital Costing Data Collection contained data from 212 public hospitals; total admissions (adults and children) were 3 519 140 at a total hospital cost of $16 187 400 000. Children accounted for 350 499 (9.9%) of the admissions at a total hospital cost of $1 931 585 123 (11.9%). Of all children, those with medical complexity accounted for 48 758 (13.9%), and their total hospital costs were $620 948 769 (32.1%). Six children's hospitals had 145 213 (41%) of the total children admissions at a total hospital cost of $936 041 843 (48%). Across the states and territories, the number of childhood admissions ranged from 9164 to 146 618 with 4.7-14.8% for children with medical complexity. Total hospital costs ranged from $44 to $592 million with 15.4-39.4% for children with medical complexity.
The national burden of hospitalised children is substantial. Children with medical complexity only account for a small percentage of hospitalisations but almost one third of total hospital costs for children, with children's hospitals bearing the major costs.
描述澳大利亚公立医院中患有复杂疾病儿童的住院费用、医院类型以及各州和领地之间的差异。
对来自六个州（不包括昆士兰州）和两个领地的212家澳大利亚公立医院进行回顾性全国行政数据库研究，这些医院向2010 - 2011年国家医院成本数据收集系统提交了成本数据。参与者包括所有住院患者，比较了成人与儿童（17岁及以下），以及患有慢性病的成人和患有复杂疾病的儿童。总住院费用是主要结局指标。
国家医院成本数据收集系统包含来自212家公立医院的数据；成人和儿童的总入院人数为3519140人，总住院费用为16187400000澳元。儿童占入院人数的350499人（9.9%），总住院费用为1931585123澳元（11.9%）。在所有儿童中，患有复杂疾病的儿童占48758人（13.9%），他们的总住院费用为620948769澳元（32.1%）。六家儿童医院的儿童入院总数为145213人（41%），总住院费用为936041843澳元（48%）。在各州和领地中，儿童入院人数从9164人到146618人不等，患有复杂疾病的儿童占4.7% - 14.8%。总住院费用从4400万澳元到5.92亿澳元不等，患有复杂疾病的儿童占15.4% - 39.4%。
住院儿童的全国负担很重。患有复杂疾病的儿童仅占住院人数的一小部分，但几乎占儿童总住院费用的三分之一，儿童医院承担了主要费用。
