@article{ref1,
title="Hospital costs and charges of discharge delays in children hospitalized for abuse and neglect",
journal="Hospital pediatrics",
year="2017",
author="Lee, Michael and Bachim, Angela and Smith, Carolyn and Camp, Elizabeth A. and Donaruma-Kwoh, Marcella and Patel, Binita",
volume="7",
number="10",
pages="572-578",
abstract="OBJECTIVES: Hospitalizations for child maltreatment cases are longer and costlier than hospitalizations for medically similar nonabuse cases. Some discharges are delayed despite medical clearance because of a lack of safe disposition, increasing the cost of hospitalization. We aim to quantify the additional charges and costs of these delays. <br><br>METHODS: A retrospective chart review evaluated the dates of medical clearance and clinical characteristics of child protection team inpatient consults from 2012 to 2014 at a 595-bed quaternary-care urban hospital. Charges and costs were compared between those with no delay, those with any delay, and those with a delay >1 day. We excluded children who were not admitted, in whom no abuse was suspected, or in whom sexual abuse was suspected absent extragenital injury. <br><br>RESULTS: Thirty-six percent (134 of 375) of children hospitalized for abuse remained hospitalized after medical clearance and 20.5% (77 of 375) of children were delayed >1 day. Among those who were delayed, the mean number of days delayed was 4.37 (SD ±7.44). Mean charges after medical clearance were $13 647.53 (±$30 172.17), and mean costs after medical clearance were $6521.93 (±$13 975.34). Both charges and costs were markedly right-skewed. Median costs after medical clearance were $1553.64 (interquartile range, $26.10-$5244.20). Cumulatively, 586 total days of delay resulted in excess charges of $1.8 million. <br><br>CONCLUSIONS: Continued hospitalization beyond medical clearance occurs often and represents a significant cost. Further study is needed to evaluate whether interventions can be targeted at children with characteristics correlated with prolonged discharge delays.<br><br>Copyright © 2017 by the American Academy of Pediatrics.<p /> <p>Language: en</p>",
language="en",
issn="2154-1663",
doi="10.1542/hpeds.2017-0027",
url="http://dx.doi.org/10.1542/hpeds.2017-0027"
}