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Categorising high-cost high-need children and young people

Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. https://creativecommons.org/licenses/by-nc/4.0 ;ISSN: 0003-9888 ;EISSN: 1468-2044 ;DOI: 10.1136/archdischild-2021-321654

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Title:
Categorising high-cost high-need children and young people
Author: Punjabi, N ; Marszalek, K ; Beaney, T ; Shah, R ; Nicholls, D ; Deeny, S ; Hargreaves, D
Subjects: 1103 Clinical Sciences ; 1114 Paediatrics and Reproductive Medicine ; 1117 Public Health and Health Services ; Adolescent ; CARE ; Child ; Delivery of Health Care ; epidemiology ; Female ; Health Care Costs ; health care economics and organizations ; health services research ; Hospitalization ; Humans ; Life Sciences & Biomedicine ; Male ; Mental Health Services ; Patient Acceptance of Health Care ; Pediatrics ; Retrospective Studies ; Science & Technology
Description: Objectives To describe the characteristics of high-cost high-need children and young people (CYP) (0–24 years) in England. Methods Retrospective observational study using data from the Clinical Practice Research Database linked to Hospital Episode Statistics in 2014/2015 and 2015/2016. Healthcare utilisation of primary and secondary care services were calculated, and costs were estimated using Healthcare Resource Group for secondary care and Personal Social Services Research Unit for primary care. High-cost high-need CYP were defined as the top 5% of users by cost. Results 3891 of 73 392 CYP made up the top 5% that were classified as high-cost high-need, and this group accounted for 54% of total annual costs. In this population, 7.3% were males <5 years and 11.0% were females 20–24 years. Inpatient care (acute) accounted for 63% of known spending in high-cost high-need patients. Total mean monthly cost per patient was 22.7 times greater in the high-cost high-need group compared with all other patients (£4417 vs £195). 29% of CYP in the high-cost high-need group in 2014/2015 were also classified as high-cost high-need in the following year. Conclusions These findings indicate the importance of further understanding and anticipating trends in CYP health spending to optimise care, reduce costs and inform new models of care. This includes integrated services, a further look into societal factors in reducing health inequalities and a particular focus of mental health services, the demand of which increases with age.
Publisher: BMJ Publishing Group
Creation Date: 2021-08
Language: English
Identifier: ISSN: 0003-9888
EISSN: 1468-2044
DOI: 10.1136/archdischild-2021-321654
Source: Spiral
Alma/SFX Local Collection
ProQuest Central

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Categorising high-cost high-need children and young people

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