261193 Hospital use, associated charges, and payer status for infants born with spina bifida

Monday, October 29, 2012 : 11:00 AM - 11:15 AM

Elizabeth Radcliff, MSPH , College of Health & Human Services, University of North Carolina at Charlotte, Charlotte, NC
Cynthia Cassell, PhD , National Center on Birth Defects and Developmental Disabilities, Division of Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
Jean Paul Tanner, MPH , 4 Birth Defects Surveillance Program, Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL
Russell Kirby, PhD , Maternal and Child Health, University of South Florida, Tampa, FL
Sharon Watkins, PhD , Analytical Environmental Epidemiology Program, Florida Department of Health, Bureau of Environmental Public Health Medicine, Tallahassee, FL
Jane Correia, BS , Florida Birth Defects Registry, Florida Department of Health, Bureau of Environmental Public Health Medicine, Tallahassee, FL
Cora Peterson, PhD , Division of Birth Defects and Developmental Disabilities, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, DHHS, Atlanta, GA
Scott Grosse, PhD , National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
Background: Healthcare use and costs for children with spina bifida are significantly greater than those of unaffected children. We examined hospital use and charges by health insurance payer type during the first year of life and changes in payer status for infants born with spina bifida.

Methods: This was a retrospective, population-based study of infants with spina bifida without anencephaly born in Florida 1998-2007. Infants were identified by the Florida Birth Defects Registry and linked to hospital discharge records. Descriptive statistics on hospitalizations, length of stay, and inpatient charges were calculated. Results were stratified by selected sociodemographic and clinical characteristics, including payer type.

Results: Of 615 infants with spina bifida, 27% were born preterm and 20% were born low birthweight or very low birthweight. Infants had a mean and median of 2.7 and 2 hospitalizations and 8.8 and 4.0 hospitalized days, respectively. Mean and median total hospital charges per infant were $129,778 and $72,034, respectively. Maternal race/ethnicity and age and marital status were significantly associated with number of hospitalized days and total charges. Almost 60% of hospitalizations were paid by a public payer source. About 10% of infants had a mix of payers from public and private health insurance.

Conclusions: Substantial differences between median and mean length of hospital stay and charges suggests a small percentage of infants have multiple hospitalizations with high charges. Results suggest certain comorbidities and demographic factors may influence hospital use and charges. Further examination of these factors and data from multiple payer sources are warranted.

Learning Areas:
Public health or related research

Learning Objectives:
1. Describe hospital use and charges for infants with spina bifida 2. Describe percentage of infants with public health insurance and those with changes in payer status

Keywords: Children With Special Needs, Health Care Utilization

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a pediatric nurse, have a masters in public health, and am project manager for the research grant which is examining this data.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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