Pediatric sports-related lower extremity fractures: hospital length of stay and charges: what is the role of the primary payer?
OBJECTIVE
The purposes of this study were (a) to evaluate the distribution by primary payer (public vs. private) of U.S. pediatric patients aged 5-18 years who were hospitalized with a sports-related lower extremity fracture and (b) to discern the adjusted mean hospital length of stay and mean charge per day by payer type.


METHODS
Children who were aged 5 to 18 years and had diagnoses of lower extremity fracture and sports-related injury in the 2006 Healthcare Cost and Utilization Project Kids' Inpatient Database were included. Lower extremity fractures are defined as International Classification of Diseases, 9th Revision, Clinical Modification codes 820-829 under Section "Injury and Poisoning (800-999)," while sports-related external cause of injury codes (E-codes) are E886.0, E917.0, and E917.5. Differences in hospital length of stay and cost per day by payer type were assessed via adjusted least square mean analysis.


RESULTS
The adjusted mean hospital length of stay was 20% higher for patients with a public payer (2.50 days) versus a private payer (2.08 days). The adjusted mean charge per day differed about 10% by payer type (public, US$7,900; private, US$8,794).


CONCLUSIONS
Further research is required to identify factors that are associated with different length of stay and mean charge per day by payer type, and explore 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.
University of Iowa, Department of Orthopaedics and Rehabilitation, 200 Hawkins Drive Iowa City, IA 52242, USA.
Yubo
Y
Gao
Richard C
RC
Johnston
Matthew
M
Karam
D000293:Adolescent; D001265:Athletic Injuries / Q000145:classification / Q000191:economics*; D050281:Bones of Lower Extremity / Q000293:injuries*; D002648:Child; D002675:Child, Preschool; D059019:Clinical Coding; D005260:Female; D005380:Financing, Government / Q000145:classification / Q000191:economics*; D050723:Fractures, Bone / Q000145:classification / Q000191:economics*; D017722:Hospital Charges / Q000706:statistics & numerical data*; D006801:Humans; D007348:Insurance, Health / Q000145:classification / Q000191:economics*; D007902:Length of Stay / Q000191:economics*; D008297:Male; D010351:Patient Discharge / Q000706:statistics & numerical data; D012189:Retrospective Studies