Hospital length of stay for children and adolescents diagnosed with depression: is primary payer an influencing factor?

Sclar, David A.; Robison, Linda M.; Gavrun, Corrine; Skaer, Tracy L.

doi:10.1016/j.genhosppsych.2007.08.003

« Previous Next »General Hospital Psychiatry
Volume 30, Issue 1 , Pages 73-76, January 2008

Hospital length of stay for children and adolescents diagnosed with depression: is primary payer an influencing factor?

David A. Sclar, B.Pharm., Ph.D.
- Pharmacoeconomics and Pharmacoepidemiology Research Unit, Washington State University, P.O. Box 646510, Pullman, WA 99164-6510, USA
- Department of Health Policy and Administration, Washington State University, Pullman, P.O. Box 646510, Pullman, WA 99164-6510, USA
- Department of Statistics, Washington State University, Pullman, P.O. Box 646510, Pullman, WA 99164-6510, USA
- Department of Pharmacotherapy, Washington State University, P.O. Box 646510, Pullman, WA 99164-6510, USA
- Washington Institute for Mental Illness Research and Training, Spokane, WA 99210-1495, USA
- Corresponding author. Pharmacoeconomics and Pharmacoepidemiology Research Unit, Department of Health Policy and Administration, Washington State University, P.O. Box 646510, Pullman, WA 99164-6510, USA. Tel.: +1 509 335 8039; fax: +1 509 335 4775.
Linda M. Robison, M.S.P.H.
- Pharmacoeconomics and Pharmacoepidemiology Research Unit, Washington State University, P.O. Box 646510, Pullman, WA 99164-6510, USA
- Department of Health Policy and Administration, Washington State University, Pullman, P.O. Box 646510, Pullman, WA 99164-6510, USA
Corrine Gavrun, M.B.A.
- Pharmacoeconomics and Pharmacoepidemiology Research Unit, Washington State University, P.O. Box 646510, Pullman, WA 99164-6510, USA
Tracy L. Skaer, B.Pharm., Pharm.D.
- Pharmacoeconomics and Pharmacoepidemiology Research Unit, Washington State University, P.O. Box 646510, Pullman, WA 99164-6510, USA
- Department of Health Policy and Administration, Washington State University, Pullman, P.O. Box 646510, Pullman, WA 99164-6510, USA
- Department of Pharmacotherapy, Washington State University, P.O. Box 646510, Pullman, WA 99164-6510, USA

Received 6 July 2007; accepted 8 August 2007.

Abstract

Objective

This study aimed (a) to discern the distribution by primary payer (public vs. private) of U.S. patients aged 5–18 years who were hospitalized with a primary diagnosis of depression and (b) to discern the mean hospital length of stay and mean charge per day by payer type.

Methods

The 2003 Healthcare Cost and Utilization Project Kids' Inpatient Database was used for this analysis. Depression was defined as International Classification of Diseases, 9th Revision, Clinical Modification codes 296.2–296.36, 300.4 or 311. Differences in hospital length of stay and mean cost per day by payer type were discerned via adjusted least square mean analysis (±S.E.).

Results

The adjusted mean hospital length of stay was significantly higher (P<.0001) for patients with a public payer (6.6±0.05 days) versus a private payer (5.3±0.05 days). Although statistically significant (P<.0001), the adjusted mean charge per day differed little by payer type (public, US$1316.39±9.82; private, US$1357.51±9.07).

Conclusions

Further research is required to discern whether observed differences in hospital length of stay are the result of private payers enhancing patient care, thereby discharging patients in a more efficient manner, or the patients being discharged prematurely from the hospital due to constraints in reimbursement by private payers.

Keywords: Children, Depression, Healthcare Cost and Utilization Project, Length of stay, Payer