title: Hospital use, associated costs, and payer status for infants born with spina bifida.
abstract: BACKGROUND
  Health care use and costs for children with spina bifida (SB) are significantly greater than those of unaffected children. Little is known about hospital use and costs across health insurance payer types. We examined hospitalizations and associated costs by sociodemographic characteristics and payer type during the first year of life among children with SB. We also examined changes in health insurance payer status.
  
  
  METHODS
  This study was a retrospective, statewide population-based analysis of infants with SB without anencephaly born in Florida during 1998-2007. Infants were identified by the Florida Birth Defects Registry and linked to hospital discharge records. Descriptive statistics on number of hospitalizations, length of stay, and estimated hospital costs per hospitalization and per infant were calculated during the first year of life. Results were stratified by selected sociodemographic variables and health insurance payer type.
  
  
  RESULTS
  Among 615 infants with SB, mean and median numbers of hospitalizations per infant were 2.4 and 2.0, respectively. Mean and median total days of hospitalization per infant were 25.2 and 14.0 days, respectively. Approximately 18% of infants were hospitalized more than three times. Among infants with multiple hospitalizations, 16.7% had a mix of public and private health insurance payers. Almost 60% of hospitalizations for infants were paid by public payer sources. Mean and median estimated hospital costs per infant were $39,059 and $21,937, respectively.
  
  
  CONCLUSIONS
  Results suggest a small percentage of infants with SB have multiple hospitalizations with high costs. Further analysis on factors associated with length of stay, hospitalizations, and costs is warranted.
authors.affiliation: Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina 28223, USA. eradclif@uncc.edu
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Radcliff
authors.forename: Cynthia H
authors.initials: CH
authors.lastname: Cassell
authors.forename: Jean Paul
authors.initials: JP
authors.lastname: Tanner
authors.forename: Russell S
authors.initials: RS
authors.lastname: Kirby
authors.forename: Sharon
authors.initials: S
authors.lastname: Watkins
authors.forename: Jane
authors.initials: J
authors.lastname: Correia
authors.forename: Cora
authors.initials: C
authors.lastname: Peterson
authors.forename: Scott D
authors.initials: SD
authors.lastname: Grosse
mesh_terms: D000328:Adult; D002648:Child; D005260:Female; D005431:Florida / Q000453:epidemiology; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D019458:Insurance Coverage / Q000191:economics; D007348:Insurance, Health / Q000191:economics*; D007902:Length of Stay / Q000191:economics* / Q000706:statistics & numerical data; D008297:Male; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D016135:Spinal Dysraphism / Q000191:economics* / Q000453:epidemiology; D055815:Young Adult