What are the common but costly conditions treated at hospitals?

In a hospital setting, awareness of medical conditions that are most prevalent, have the highest costs, or greatest variations in costs can be helpful in determining which could most benefit from research funding. A report in JAMA Network Open gives necessary insight.¹

Investigators performed a retrospective cohort study of children who had hospital encounters at 45 tertiary care US children’s hospitals. The Pediatric Clinical Classification System was used to classify the primary diagnosis discharge code. The Cost Master Index was used to determine the standard cost of hospital goods and services used for care, in order to eliminate the high variation in those costs across hospitals.

There were 2,882,490 inpatient hospital encounters included in the report. From a list of 50 most prevalent and 50 most costly conditions, there were 74 total conditions, of which 49 (66.2%) were medical, 15 (20.3%) were surgical, and 10 (13.5%) were medical/surgical. The top 10 costly conditions made up $12.4 billon of $33.4 billon total costs and 33.8% of all of the conditions. The highest cost per encounter was seen with extreme immaturity conditions (ie, birth weight 500-749 g) at $382,910 (95% CI, $368,084-$397,736). The highest degree of interhospital variability in cost was seen with major depressive disorder, type 1 diabetes with complications, diabetic ketoacidosis, and acute appendicitis without peritonitis. Conditions that had high prevalence, variation in cost, and overall cost were major depressive disorder (cost rank, 19; prevalence rank, 10), scoliosis (cost rank, 6; prevalence rank, 38), acute appendicitis with peritonitis (cost rank, 13; prevalence rank, 11), asthma (cost rank, 10; prevalence rank, 2), and dehydration (cost rank, 24; prevalence rank, 8).

Those in charge of determining where to allocate research funding for improved care and outcomes should keep in mind the conditions that were found to be most common and costly.

Reference

1. Gill P, Anwar M, Thavam T, et al. Identifying conditions with high prevalence, cost, and variation in cost in US children’s hospitals. JAMA Netw Open. 2021;4(7):e2117816. doi:10.1001/jamanetworkopen.2021.17816