Department of Economics, Carl H. Lindner College of Business,
Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio; and.
Pediatrics. 2018 Sep;142(3). doi: 10.1542/peds.2018-0195. Epub 2018 Aug 13.
Hospitalization-related nonmedical costs, including lost earnings and expenses such as transportation, meals, and child care, can lead to challenges in prioritizing postdischarge decisions. In this study, we quantify such costs and evaluate their relationship with sociodemographic factors, including family-reported financial and social hardships.
This was a cross-sectional analysis of data collected during the Hospital-to-Home Outcomes Study, a randomized trial designed to determine the effects of a nurse home visit after standard pediatric discharge. Parents completed an in-person survey during the child's hospitalization. The survey included sociodemographic characteristics of the parent and child, measures of financial and social hardship, household income and also evaluated the family's total nonmedical cost burden, which was defined as all lost earnings plus expenses. A daily cost burden (DCB) standardized it for a 24-hour period. The daily cost burden as a percentage of daily household income (DCBi) was also calculated.
Median total cost burden for the 1372 households was $113, the median DCB was $51, and the median DCBi was 45%. DCB and DCBi varied across many sociodemographic characteristics. In particular, single-parent households (those with less work flexibility and more financial hardships experienced significantly higher DCB and DCBi. Those who reported ≥3 financial hardships lost or spent 6-times more of their daily income on nonmedical costs than those without hardships. Those with ≥1 social hardships lost or spent double their daily income compared with those without social hardships.
Nonmedical costs place burdens on families of children who are hospitalized, disproportionately affecting those with competing socioeconomic challenges.
与住院相关的非医疗费用，包括失去的收入和交通、膳食、儿童保育等方面的支出，可能导致在优先考虑出院后决策时面临挑战。本研究旨在量化这些成本，并评估其与社会人口学因素的关系，包括家庭报告的经济和社会困难。
这是一项横断面分析，数据来自 Hospital-to-Home Outcomes 研究，该研究是一项随机试验，旨在确定护士在标准儿科出院后家访对出院后决策的影响。父母在孩子住院期间完成了一次面对面的调查。调查包括父母和孩子的社会人口学特征、经济和社会困难程度的衡量标准、家庭收入，还评估了家庭的总非医疗费用负担，这被定义为所有失去的收入加上支出。每日成本负担（DCB）将其标准化为 24 小时。还计算了每日成本负担占家庭日收入的百分比（DCBi）。
1372 户家庭的中位数总费用负担为 113 美元，中位数 DCB 为 51 美元，中位数 DCBi 为 45%。DCB 和 DCBi 在许多社会人口学特征上存在差异。特别是单亲家庭（那些工作灵活性较低且经济困难较大的家庭）的 DCB 和 DCBi 显著较高。报告≥3 项经济困难的家庭在非医疗费用上的支出或损失是没有经济困难家庭的 6 倍。有≥1 项社会困难的家庭在非医疗费用上的支出或损失是没有社会困难家庭的两倍。
非医疗费用给住院儿童的家庭带来了负担，那些面临更多竞争的社会经济挑战的家庭负担更为沉重。
