Mueller Emily L, Hall Matt, Berry Jay G, Carroll Aaron E, Macy Michelle L
Section of Pediatric Hematology Oncology, Department of Pediatrics, Indiana University, Indianapolis, Indiana.
Department of Pediatrics, Center for Pediatric and Adolescent Comparative Effectiveness Research, Indiana University, Indianapolis, Indiana.
Pediatr Blood Cancer. 2017 Nov;64(11). doi: 10.1002/pbc.26569. Epub 2017 Apr 18.
Children with cancer are a unique patient population with high resource, complex healthcare needs. Understanding their healthcare utilization could highlight areas for care optimization.
We performed a retrospective, cross-sectional analysis of the 2014 Truven Marketscan Medicaid Database to explore clinical attributes, utilization, and spending among children with cancer who were Medicaid enrollees. Eligible patients included children (ages 0-18 years) with cancer (Clinical Risk Group 8). Healthcare utilization and spending (per member per month, PMPM) were assessed overall and across specific healthcare services.
Children with cancer (n = 5,405) represent less than 1% of the 1,516,457 children with medical complexity in the dataset. Children with cancer had high services use: laboratory/radiographic testing (93.0%), outpatient specialty care (83.4%), outpatient therapy/treatment (53.4%), emergency department (43.7%), hospitalization (31.5%), home healthcare (9.5%). PMPM spending for children with cancer was $3,706 overall and $2,323 for hospital care.
Children with cancer have high healthcare resource use and spending. Differences in geographic distribution of services for children with cancer and the trajectory of spending over the course of therapy are areas for future investigation aimed at lowering costs of care without compromising on health outcomes.
患癌儿童是一个独特的患者群体，他们对资源的需求高，医疗保健需求复杂。了解他们的医疗保健利用情况有助于找出可优化护理的领域。
我们对2014年Truven Marketscan医疗补助数据库进行了一项回顾性横断面分析，以探究医疗补助参保的患癌儿童的临床特征、利用率和支出情况。符合条件的患者包括患有癌症的儿童（0至18岁）（临床风险组8）。总体上以及针对特定医疗服务评估了医疗保健利用率和支出（每人每月，PMPM）。
患癌儿童（n = 5405）在数据集中1516457名医疗情况复杂的儿童中占比不到1%。患癌儿童的服务使用率很高：实验室/放射检查（93.0%）、门诊专科护理（83.4%）、门诊治疗（53.4%）、急诊科（43.7%）、住院治疗（31.5%）、家庭医疗保健（9.5%）。患癌儿童的总体PMPM支出为3706美元，住院护理支出为2323美元。
患癌儿童的医疗保健资源使用和支出很高。患癌儿童服务的地理分布差异以及治疗过程中的支出轨迹是未来调查的领域，旨在在不影响健康结果的情况下降低护理成本。
