To compare inpatient hospital charges generated within a children's hospital by academic and nonacademic pediatric services for common medical diagnoses.
Hospital admissions to a free-standing children's hospital between 9/1/90 and 8/30/94 were selected for patients who were hospitalized 1 to 14 days, with one of six selected diagnoses, and with discharge attending of record either a private pediatrician or an academic sub-specialist.
Discharge diagnoses, based on ICD-9 codes, included asthma (n=1983), bronchiolitis (n=692), gastroenteritis (n=733), rule out sepsis (n=1065), urinary tract infection (n=516), and viral meningitis (n=288).
Charges associated with patient records were dichotomized as above or below the median charge for each diagnostic category.
Each category was analyzed separately using a logistic regression model where the dichotomous-dependent variable was charges above the median charge for each diagnosis.
Independent variables included physician type, payor status, patient residence, ICD-9 code as primary or secondary diagnosis, patient age, and presence of complicating conditions.
By univariate comparison, academic physicians cared for a higher percentage of underinsured patients, and their care was more expensive.
Complicated claims were associated with higher charges than uncomplicated claims for all diagnostic categories. (...)
Mots-clés Pascal : Hospitalisation, Enfant, Homme, Etats Unis, Amérique du Nord, Amérique, Coût, Etude comparative, Hôpital général, Centre hospitalier universitaire, Nourrisson
Mots-clés Pascal anglais : Hospitalization, Child, Human, United States, North America, America, Costs, Comparative study, General hospital, Teaching hospital, Infant
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0185285
Code Inist : 002B30A04B. Création : 21/05/1997.