Study Examines Balancing Cost Containment, Quality Care for Surgeries at Children’s Hospitals

More research is needed to determine how children’s hospitals can keep costs in check while maintaining high-quality specialty surgical care, according to an AHRQ-funded article based on data from AHRQ’s Healthcare Cost and Utilization Project Kids’ Inpatient Database. Researchers reviewed data from 2000 to 2009 identifying all cases of common pediatric surgical procedures. They concluded that the proportion of common surgeries performed at children’s hospitals was outpacing the proportion of surgeries at non-children’s hospitals, despite lack of evidence of higher quality. Costs for certain procedures, meanwhile, were higher at children’s hospitals than non-children’s hospitals, leading to overall growth in the cost of children’s surgery. Access the abstract.

2017 Nov 23. pii: S0022-3468(17)30773-X. doi: 10.1016/j.jpedsurg.2017.11.053. [Epub ahead of print]

Trends in common surgical procedures at children's and nonchildren's hospitals between 2000 and 2009.

Short HL1, Sarda S2, Travers C3, Hockenberry JM2, McCarthy I4, Raval MV5.

Author information

Abstract

PURPOSE:

Though growth in children's surgical expenditures has been documented, procedure-specific differences in volume and costs at children's hospitals (CH) and non-hildren's hospitals (NCH) have not been explored. Our purpose was to compare trends in volume and costs of common pediatric surgical procedures between CH and NCH.

METHODS:

We performed a review of the 2000-2009 Kids' Inpatient Database identifying all cases of appendectomy for uncomplicated appendicitis (AP), tonsillectomy and adenoidectomy (TA), fundoplication (FP), humeral fracture repair (HFR), pyloromyotomy (PYL), and cholecystectomy (CHOLE). Trends in case volume and costs were examined at CH versus NCH.

RESULTS:

The proportion of surgical care at CH increased for all procedures from 2000 to 2009. TA and CHOLE demonstrated higher costs per case at CH. Positive growth over time in cost per case at CH was seen for AP and FP, with the cost per case of FP increasing by 21% between 2006 and 2009.

CONCLUSIONS:

The proportion of surgeries performed at CH is continuing to grow alongside proportionate increases in costs, however costs for certain procedures are higher at CH than NCH. Further investigation is needed to explore cost containment at CH while still maintaining specialized, high quality surgical care.