{"title":"Clinical Outcomes and Medical Costs of Hospitalized Children Requiring Daily Medical Care in Japan.","authors":"Osamu Matsumura Momo, Susumu Kunisawa, Kenji Kishimoto, Kiyohide Fushimi, Yuichi Imanaka","doi":"10.2188/jea.JE20240457","DOIUrl":null,"url":null,"abstract":"<p><p>BackgroundThis study aimed to describe the clinical outcomes and medical costs of hospitalized children requiring daily medical care (CRDMC), a patient group for which government-led support has developed rapidly in Japan.MethodsA retrospective longitudinal study was conducted using a nationwide administrative database. All hospitalizations of children aged under 18 years discharged from April 2014 to March 2021 were included. Clinical outcomes and medical costs were compared between CRDMC and non-CRDMC hospitalizations. The estimated increase in the proportion of CRDMC medical costs among all pediatric hospitalizations during the study period was also calculated.ResultsAmong the 1,531,456 hospitalizations included, 91,413 were identified as CRDMC. CRDMC accounted for 3.7% of the annual unique inpatients. The 30-day readmission rate among CRDMC was 27.5%, and the rate among those receiving multiple types of medical care was higher at 33.7%. The inpatient medical cost of CRDMC accounted for 20.3% of pediatric inpatient medical costs, with an estimated rise of 1.2881 (95% CI, 1.2110-1.3702) during the study period. In the breakdown of the medical costs, the proportion of injection drug fees increased most rapidly.ConclusionsThe high 30-day readmission rate in CRDMC was distinctive among the clinical outcomes. The proportion of medical costs for CRDMC in pediatric inpatients was high, although CRDMC accounted for only a small proportion of annual unique inpatients. Further support for CRDMC must be based on the unique characteristics of this population.</p>","PeriodicalId":15799,"journal":{"name":"Journal of Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.7000,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Epidemiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2188/jea.JE20240457","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0
Abstract
BackgroundThis study aimed to describe the clinical outcomes and medical costs of hospitalized children requiring daily medical care (CRDMC), a patient group for which government-led support has developed rapidly in Japan.MethodsA retrospective longitudinal study was conducted using a nationwide administrative database. All hospitalizations of children aged under 18 years discharged from April 2014 to March 2021 were included. Clinical outcomes and medical costs were compared between CRDMC and non-CRDMC hospitalizations. The estimated increase in the proportion of CRDMC medical costs among all pediatric hospitalizations during the study period was also calculated.ResultsAmong the 1,531,456 hospitalizations included, 91,413 were identified as CRDMC. CRDMC accounted for 3.7% of the annual unique inpatients. The 30-day readmission rate among CRDMC was 27.5%, and the rate among those receiving multiple types of medical care was higher at 33.7%. The inpatient medical cost of CRDMC accounted for 20.3% of pediatric inpatient medical costs, with an estimated rise of 1.2881 (95% CI, 1.2110-1.3702) during the study period. In the breakdown of the medical costs, the proportion of injection drug fees increased most rapidly.ConclusionsThe high 30-day readmission rate in CRDMC was distinctive among the clinical outcomes. The proportion of medical costs for CRDMC in pediatric inpatients was high, although CRDMC accounted for only a small proportion of annual unique inpatients. Further support for CRDMC must be based on the unique characteristics of this population.
期刊介绍:
The Journal of Epidemiology is the official open access scientific journal of the Japan Epidemiological Association. The Journal publishes a broad range of original research on epidemiology as it relates to human health, and aims to promote communication among those engaged in the field of epidemiological research and those who use epidemiological findings.