Continuity of Care Is Associated with Medical Costs and Inpatient Days in Children with Cerebral Palsy.

Kuang-Tsu Yang,Chun-Hao Yin,Tsu-Jen Kuo,Ching-Chih Lee,Shih-Ju Huang,Yao-Min Hung

doi:10.3390/ijerph17082913

Abstract

Background: Children with cerebral palsy (CP) place a considerable burden on medical costs and add to an increased number of inpatient days in Taiwan. Continuity of care (COC) has not been investigated in this population thus far. Materials and Methods: We designed a retrospective population-based cohort study using Taiwan’s National Health Insurance Research Database. Patients aged 0 to 18 years with CP catastrophic illness certificates were enrolled. We investigated the association of COC index (COCI) with medical costs and inpatient days. We also investigated the possible clinical characteristics affecting the outcome. Results: Over five years, children with CP with low COCI levels had higher medical costs and more inpatient days than did those with high COCI levels. Younger age at CP diagnosis, more inpatient visits one year before obtaining a catastrophic illness certificate, pneumonia, and nasogastric tube use increased medical expenses and length of hospital stay. Conclusions: Improving COC reduces medical costs and the number of inpatient days in children with CP. Certain characteristics also influence these outcomes.

Highlights

Cerebral palsy (CP), the most common childhood-onset and permanent physical disability in numerous countries, is characterized by a neurodevelopmental disorder that affects muscle tone, movement, and motor skills
We demonstrated that a low Continuity of care (COC) was associated with an increased number of inpatient days and more medical costs among children with cerebral palsy (CP)
Lower COC index (COCI) was associated with higher medical costs, in ambulatory patients with CP. These findings indicated that changing physicians was correlated with a large increase in medical costs associated with outpatient visits, and, to a lesser extent, increased medical costs resulting from inpatient visits

Summary

Introduction

Cerebral palsy (CP), the most common childhood-onset and permanent physical disability in numerous countries, is characterized by a neurodevelopmental disorder that affects muscle tone, movement, and motor skills. Children with cerebral palsy (CP) place a considerable burden on medical costs and add to an increased number of inpatient days in Taiwan. We investigated the association of COC index (COCI) with medical costs and inpatient days. Results: Over five years, children with CP with low COCI levels had higher medical costs and more inpatient days than did those with high COCI levels. Younger age at CP diagnosis, more inpatient visits one year before obtaining a catastrophic illness certificate, pneumonia, and nasogastric tube use increased medical expenses and length of hospital stay. Conclusions: Improving COC reduces medical costs and the number of inpatient days in children with CP.

Methods

Results

Discussion

Conclusion