Characteristics of hospitalizations for people with developmental disabilities: utilization, costs, and impact of care coordination.
Hospitalizations and the impact of care coordination were studied in two large databases for people with developmental disabilities. Acute care admissions for alternate years between 1983 and 1991 were analyzed and compared to the data for the nondisabled population of New Jersey. The statewide dataset included 22,294 admissions; the coordinated dataset included 692 admissions to a community hospital. Under the diagnostic-related group reimbursement system, admissions for the general population remained constant, whereas hospital days and average length of stay dropped during the study period. Increases in admissions (56%) and days (42%) were found for people with developmental disabilities. Their total hospital charges rose 206%, almost twice the rate for the general population. Care coordination moderated all of these differences.
Walsh
K K
KK
Center for Human Development, Morristown Memorial Hospital, NJ 07962-1956, USA.
Kastner
T
T
Criscione
T
T
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D019090:Case Management / Q000191:economics*; D002648:Child; D003363:Cost Control / Q000379:methods; D003362:Cost-Benefit Analysis; D016208:Databases, Factual; D002658:Developmental Disabilities / Q000191:economics* / Q000628:therapy; D003953:Diagnosis-Related Groups / Q000191:economics*; D004180:Direct Service Costs / Q000639:trends; D005260:Female; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data; D007902:Length of Stay / Q000639:trends; D008297:Male; D006278:Medicare / Q000191:economics; D008875:Middle Aged; D015999:Multivariate Analysis; D009515:New Jersey; D010343:Patient Admission / Q000639:trends; D012189:Retrospective Studies; D014481:United States