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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Expenditures for care of children with chronic illnesses enrolled in the Washington State Medicaid program, fiscal year 1993.
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Expenditures for care of children with chronic illnesses enrolled in the Washington State Medicaid program, fiscal year 1993.

机译：1993财政年度参加华盛顿州医疗补助计划的慢性病儿童护理支出。

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OBJECTIVE: We calculated expenditures for children with one of eight selected chronic health conditions who were enrolled in the Washington State Medicaid program and compared them with payments for all Medicaid-enrolled children. We examined variation in mean, median, and total expenditures and identified expenditure sources. METHODS: This study analyzed Medicaid claims data for 310 977 children aged 0 to 18 who were enrolled at any time in fiscal year 1993. Tracer conditions were used to examine expenditure variation within and between diagnostic groupings. A total of 18 233 children (5.9%) had at least one of the conditions. Expenditures were calculated based on payments made by the Medicaid program. RESULTS: Children with one of the eight selected conditions incurred mean expenditures of Dollars 3800, compared with Dollars 955 for all Medicaid-enrolled children. Mean payments associated with the selected conditions ranged from 2.5 times to 20 times more than payments to all children. Approximately 10% of children accounted for approximately 70% of the payments in general and in each diagnostic grouping. Variation in mean, median, and total expenditures was extensive among the conditions. For most conditions, inpatient stays accounted for the greatest proportion of expenditures; for some conditions, durable equipment, home nursing, and medication-related services accounted for substantial proportions of total expenditures. CONCLUSIONS: Medical care for children with selected chronic health conditions is 2.5 to 20 times more expensive than children in general, depending on the condition. A relatively few children account for the majority of expenditures. Extensive variation in mean, median, and total expenditures suggests that different conditions will need to be kept distinct for purposes of establishing payment rates. Children with certain conditions are vulnerable to restrictions in specific services, depending on what restrictions are imposed by a financing program. Further analyses are needed to identify risk-adjustment strategies to support delivery of high-quality services to this population of children as they migrate into managed-care environments.
机译：目的：我们计算了参加华盛顿州医疗补助计划的患有八种选定慢性健康状况之一的儿童的支出，并将其与所有参加医疗补助的儿童的支出进行了比较。我们检查了平均支出，中位数支出和总支出的差异，并确定了支出来源。方法：本研究分析了1993财政年度中任何时候招募的310 977名0至18岁儿童的医疗补助索赔数据。使用示踪剂条件检查诊断组内和诊断组之间的支出差异。共有18 233名儿童（5.9％）患有至少一种疾病。支出是根据医疗补助计划的付款计算的。结果：患有选择的八种疾病之一的儿童的平均支出为3800美元，而所有参加Medicaid的儿童的平均支出为955美元。与所选条件相关的平均付款额是对所有儿童的付款额的2.5倍至20倍。在每个诊断组中，大约10％的儿童约占总付款额的70％。在这些条件下，平均支出，中位数支出和总支出的差异很大。在大多数情况下，住院费用占支出的最大比例;在某些情况下，耐用设备，家庭护理和与药物相关的服务在总支出中占很大比例。结论：根据情况的不同，患有某些慢性疾病的儿童的医疗费用比一般儿童高2.5至20倍。相对较少的孩子占了大部分支出。平均支出，中位数支出和总支出的广泛差异表明，为了确定支付率，需要保持不同的条件。有条件的儿童容易受到特定服务的限制，具体取决于资助计划施加的限制。需要进一步的分析，以确定风险调整策略，以支持向这些儿童迁移到托管护理环境中时提供高质量的服务。

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