Citation

Kupfer GM, Giardino AP. Child Abuse Negl. 1995; 19(3): 291-295.

Affiliation

Department of Pediatrics, Children's Hospital of Philadelphia, PA, USA.

Copyright

(Copyright © 1995, Elsevier Publishing)

DOI

unavailable

PMID

9278728

Abstract

OBJECTIVE: To characterize third party payor types and rates of reimbursement for hospital costs in emergency department (ED) evaluations of preadolescents presenting as suspected victims of sexual abuse (SSA). DESIGN AND METHODS: Retrospective chart review, comparing a set of 186 SSA patients with 623 evaluated for upper limb fracture and cumulative reimbursement and insurance data for all patients presenting to the ED during a 12-month period. RESULTS: A greater percentage of SSA patients was uninsured (N = 96, 52%) as compared to patients with fractures (N = 9, 1%); 23% of all ED billing came from the uninsured. Of the 96 self-pay SSA patients' bills only 4% reimbursement was received. Of the insured, a greater percentage of the SSA patients was covered by publicly-funded plans (n = 59, 66%) as compared to fracture patients (N = 327, 52%). A lower percentage of insured SSA bill reimbursement was received from publicly-funded insurance than from commercial insurance (28% vs. 58%). CONCLUSIONS: Hospital costs of SSA patients are more often and to a greater degree underwritten by the hospital itself as a result of lower reimbursement and a higher percentage of uninsured and publicly-funded plans in that group, raising critical questions about how care for children with serious socially-based diagnoses is delivered and funded.

Language: en