Room cost remains biggest cost in pediatric hospitalizations

Tackling costs and improving quality of care have been 2 of the biggest challenges in health care over the past decade. A new study in Pediatrics looked at whether improvement initiatives in hospitals were linked to any potential financial benefits.¹

Investigators did a retrospective cross-sectional analysis of pediatric patients aged 0 to 21 years who had been treated in 48 children’s hospitals that were included in the Pediatric Health Information System database. They included hospitalizations for seizure, bronchiolitis, asthma, pneumonia, acute gastroenteritis, upper respiratory tract infection, other gastrointestinal diagnoses, and skin and soft tissue infection. They also categorized the distribution of hospitalization costs as clinical, laboratory, room, imaging, pharmacy, supplies, and other.

In 195,436 hospitalizations, the room costs were 52.5% to 70.3% of the total hospitalization costs. They also observed a wide variation on the hospital level in nonroom costs for the same diagnoses:

·      25%-81% for seizure

·      12%-51% for bronchiolitis

·      19%-63% for asthma

·      19%-62% for pneumonia

·      21%-78% for acute gastroenteritis

·      21%-63% for upper respiratory tract infection

·      28%-69% for other gastrointestinal diagnoses

·      21%-71% for skin and soft tissue infection

Unfortunately, to achieve a cost reduction that equaled 10% of room costs, large reductions in the nonroom cost categories were required. This indicates that significant cost savings may not be possible through individual improvement initiatives that don’t specifically address room costs.

References:

1.    Synhorst DC, Johnson MB, Bettenhausen JL, et al. Room costs for common pediatric hospitalizations and cost-reducing quality initiatives. Pediatrics. 2020;145(6):e20192177. doi: 10.1542/peds.2019-2177