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

Authors

  • Elizabeth Radcliff,

    Corresponding author
    1. Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina
    • MSPH, University of North Carolina at Charlotte, Department of Public Health Sciences, 9201 University City Blvd., Charlotte, NC 28223
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  • Cynthia H. Cassell,

    1. Division of Birth Defects and Developmental Disabilities, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
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  • Jean Paul Tanner,

    1. Birth Defects Surveillance Program, Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, Florida
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  • Russell S. Kirby,

    1. Birth Defects Surveillance Program, Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, Florida
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  • Sharon Watkins,

    1. Florida Birth Defects Registry, Florida Department of Health, Tallahassee, Florida
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  • Jane Correia,

    1. Florida Birth Defects Registry, Florida Department of Health, Tallahassee, Florida
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  • Cora Peterson,

    1. Division of Birth Defects and Developmental Disabilities, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
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  • Scott D. Grosse

    1. Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
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  • Parts of this manuscript were presented at the National Birth Defects Prevention Network meeting, February 27–29, 2012, Arlington, Virginia, and the 2nd World Congress on Spina Bifida Research and Care, March 12–14, 2012, Las Vegas, Nevada.

    The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. The authors had no financial relationships relevant to this article to disclose.

Abstract

BACKGROUND: Health care use and costs for children with spina bifida (SB) are significantly greater than those of unaffected children. Little is known about hospital use and costs across health insurance payer types. We examined hospitalizations and associated costs by sociodemographic characteristics and payer type during the first year of life among children with SB. We also examined changes in health insurance payer status. METHODS: This study was a retrospective, statewide population-based analysis of infants with SB without anencephaly born in Florida during 1998–2007. Infants were identified by the Florida Birth Defects Registry and linked to hospital discharge records. Descriptive statistics on number of hospitalizations, length of stay, and estimated hospital costs per hospitalization and per infant were calculated during the first year of life. Results were stratified by selected sociodemographic variables and health insurance payer type. RESULTS: Among 615 infants with SB, mean and median numbers of hospitalizations per infant were 2.4 and 2.0, respectively. Mean and median total days of hospitalization per infant were 25.2 and 14.0 days, respectively. Approximately 18% of infants were hospitalized more than three times. Among infants with multiple hospitalizations, 16.7% had a mix of public and private health insurance payers. Almost 60% of hospitalizations for infants were paid by public payer sources. Mean and median estimated hospital costs per infant were $39,059 and $21,937, respectively. CONCLUSIONS: Results suggest a small percentage of infants with SB have multiple hospitalizations with high costs. Further analysis on factors associated with length of stay, hospitalizations, and costs is warranted. Birth Defects Research (Part A), 2012. © 2012 Wiley Periodicals, Inc.

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