Factors that Affect Health Care Quality

Childhood seizure data is examined for inpatient cost and length amongst groups

(RxWiki News) It’s no surprise that different groups within the US receive different qualities of medical care. When it comes to the cost of care for epilepsy, billions of dollars and the quality of health care you are receiving is at stake.

A recent study examined the financial impact of inpatient seizure management in US children by evaluating hospital total costs and length of stay using a national data set.

The study showed key differences in healthcare utilization among different socioeconomic groups, including a higher likelihood for lower income households to be discharged.

"Speak to your doctor to understand treatment and hospital stays."

Shannon M. Standridge, DO, MPH, and Paul S. Horn, PhD, from the Department of Child Neurology at Children’s Hospital in Cincinnati, Ohio conducted a study on differences in hospital-related costs, charges and length of stay in discharged children with seizures and any demographic influence that contributed to these differences.

Data was collected in 2003 and 2006 from a large all-payer inpatient care database that records inpatient hospital use for youth age 0 to 20. The database is known as the Kids’ Inpatient Database (KID) from the Healthcare Cost and Utilization Project and is sponsored by the Agency for Healthcare Research and Quality.

The KID database contains de-identified patient information for 3438 hospitals in 36 states in 2003 and 3739 hospitals in 38 states in 2006. Ten percent of the total 1,692,189 discharged pediatric cases from each hospital were selected using systematic random sampling.

The data was statistically weighted for better representation of national hospitalization and reduced down to those who were just discharged for seizure.

Gender, race, age, median household income for the patient’s zip code and insurance of the patient along with ownership, teaching status, location density, region, total charges and length of stay for the hospital were examined for significant patterns.

Dr. Standridge and Dr. Horn concluded that patients with government insurance as the primary payer had a considerably longer hospital stay compared with private insurance or self-pay patients but there was no major difference in the total costs of hospitalization between the groups.

The team found that more males than females were released with seizure, most were from lower income households and the age group of 1 month to 4 years had the highest proportion of discharges followed by age group 15-20 years. These two age groups also had the longest lengths of stay.

Also at a disadvantage for seizure healthcare were Hispanics, Asian/Pacific islanders and those living in the Northeast region.

The top 50 percent of income earners did not experience a significant increase in costs between 2003 and 2006, but there was a noticeable increase in the total costs in the lower half of earners.

The authors of the study hypothesize that patients in the lower socioeconomic groups may have more complex social situations or need more resources that may require lengthier hospitalizations. Also, physicians may experience different motivations, such as having a self-pay patient, that reduce certain hospitalizations.

By understanding how social, professional and ethnic status may affect hospital visits, patients will be empowered to make decisions regarding their own health care. It is important that individuals actively participate in their treatment by discussing discharge plans with medical providers and understanding the health goals and terms of hospital release.

When it comes to your child and seizures, one can never be too informed.

The study was published in the Journal of Child Neurology.

Dr. Standridge developed the research strategy, interpreted data and wrote the manuscript for the study. Dr. Horn statistically interpreted the database and assisted with manuscript revision.

The authors received no financial support for their research and declare no conflicts of interest. However, the approval process for this study was waived by the institutional review board.

Dr. Horn is also a member of the Department of Mathematical Sciences at the University of Cincinnati in Ohio.

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Review Date: 
July 11, 2012