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Healthcare utilization and costs of pediatric home mechanical ventilation in Canada

Research output: Contribution to journalArticle

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Healthcare utilization and costs of pediatric home mechanical ventilation in Canada. / Nonoyama, Mika L.; Katz, Sherri L.; Amin, Reshma; McKim, Douglas A.; Guerriere, Denise; Coyte, Peter C.; Wasilewski, Marina; Zagorski, Brandon; Rose, Louise.

In: Pediatric Pulmonology, Vol. 55, No. 9, 01.09.2020, p. 2368-2376.

Research output: Contribution to journalArticle

Harvard

Nonoyama, ML, Katz, SL, Amin, R, McKim, DA, Guerriere, D, Coyte, PC, Wasilewski, M, Zagorski, B & Rose, L 2020, 'Healthcare utilization and costs of pediatric home mechanical ventilation in Canada', Pediatric Pulmonology, vol. 55, no. 9, pp. 2368-2376. https://doi.org/10.1002/ppul.24923

APA

Nonoyama, M. L., Katz, S. L., Amin, R., McKim, D. A., Guerriere, D., Coyte, P. C., Wasilewski, M., Zagorski, B., & Rose, L. (2020). Healthcare utilization and costs of pediatric home mechanical ventilation in Canada. Pediatric Pulmonology, 55(9), 2368-2376. https://doi.org/10.1002/ppul.24923

Vancouver

Nonoyama ML, Katz SL, Amin R, McKim DA, Guerriere D, Coyte PC et al. Healthcare utilization and costs of pediatric home mechanical ventilation in Canada. Pediatric Pulmonology. 2020 Sep 1;55(9):2368-2376. https://doi.org/10.1002/ppul.24923

Author

Nonoyama, Mika L. ; Katz, Sherri L. ; Amin, Reshma ; McKim, Douglas A. ; Guerriere, Denise ; Coyte, Peter C. ; Wasilewski, Marina ; Zagorski, Brandon ; Rose, Louise. / Healthcare utilization and costs of pediatric home mechanical ventilation in Canada. In: Pediatric Pulmonology. 2020 ; Vol. 55, No. 9. pp. 2368-2376.

Bibtex Download

@article{69cd7c82514f4768956172ab564ea7ad,
title = "Healthcare utilization and costs of pediatric home mechanical ventilation in Canada",
abstract = "Background: Children using home mechanical ventilation (HMV) live at home with better quality of life, despite financial burden for their family. Previous studies of healthcare utilization and costs have not considered public and private expenditures, including family caregiver time. Our objective was to examine public and private healthcare utilization and costs for children using HMV, and variables associated with highest costs. Methods: Longitudinal, prospective, observational cost analysis study (2012-2014) collecting data on public and private (out-of-pocket, third-party insurance, and caregiving) costs every 2 weeks for 6 months using the Ambulatory Home Care Record. Functional Independence Measure (FIM), WeeFIM, and Caregiving Impact Scale (CIS) were measured at baseline and study completion. Regression modeling examined a priori selected variables associated with monthly costs using Andersen and Newman's framework for healthcare utilization, relevant literature, and clinical expertise. Data are reported in 2015 Canadian dollars ($1CAD = $0.78USD). Results: Forty two children and their caregivers were enrolled. Overall median (interquartile range) monthly healthcare cost was $12 131 ($8159-$15 958) comprising $9929 (89%) family caregiving hours, $996 (9%) publicly funded, and $252 (2%) out-of-pocket (<1% third-party insurance) costs. With higher FIM score (lower dependency), median costs were reduced by 4.5% (95% confidence interval: 8.3%-0.5%), adjusted for age, sex, tracheostomy, and daily ventilation duration. Note: since the three cost categories did not sum to the total statistically derived median cost, the percentage of each category used the sum of median public + caregiver lost time + private out-of-pocket + third-party insurance as the denominator. Conclusions: For HMV children, most healthcare costs were due to family caregiving costs. More dependent children incur highest costs. The financial burden to family caregivers is substantial and needs to considered in future policy decisions related to pediatric HMV.",
keywords = "healthcare costs, healthcare utilization, home mechanical ventilation, long-term mechanical ventilation, pediatrics, ventilator assisted individual",
author = "Nonoyama, {Mika L.} and Katz, {Sherri L.} and Reshma Amin and McKim, {Douglas A.} and Denise Guerriere and Coyte, {Peter C.} and Marina Wasilewski and Brandon Zagorski and Louise Rose",
year = "2020",
month = sep,
day = "1",
doi = "10.1002/ppul.24923",
language = "English",
volume = "55",
pages = "2368--2376",
journal = "Pediatric Pulmonology",
issn = "8755-6863",
number = "9",

}

RIS (suitable for import to EndNote) Download

TY - JOUR

T1 - Healthcare utilization and costs of pediatric home mechanical ventilation in Canada

AU - Nonoyama, Mika L.

AU - Katz, Sherri L.

AU - Amin, Reshma

AU - McKim, Douglas A.

AU - Guerriere, Denise

AU - Coyte, Peter C.

AU - Wasilewski, Marina

AU - Zagorski, Brandon

AU - Rose, Louise

PY - 2020/9/1

Y1 - 2020/9/1

N2 - Background: Children using home mechanical ventilation (HMV) live at home with better quality of life, despite financial burden for their family. Previous studies of healthcare utilization and costs have not considered public and private expenditures, including family caregiver time. Our objective was to examine public and private healthcare utilization and costs for children using HMV, and variables associated with highest costs. Methods: Longitudinal, prospective, observational cost analysis study (2012-2014) collecting data on public and private (out-of-pocket, third-party insurance, and caregiving) costs every 2 weeks for 6 months using the Ambulatory Home Care Record. Functional Independence Measure (FIM), WeeFIM, and Caregiving Impact Scale (CIS) were measured at baseline and study completion. Regression modeling examined a priori selected variables associated with monthly costs using Andersen and Newman's framework for healthcare utilization, relevant literature, and clinical expertise. Data are reported in 2015 Canadian dollars ($1CAD = $0.78USD). Results: Forty two children and their caregivers were enrolled. Overall median (interquartile range) monthly healthcare cost was $12 131 ($8159-$15 958) comprising $9929 (89%) family caregiving hours, $996 (9%) publicly funded, and $252 (2%) out-of-pocket (<1% third-party insurance) costs. With higher FIM score (lower dependency), median costs were reduced by 4.5% (95% confidence interval: 8.3%-0.5%), adjusted for age, sex, tracheostomy, and daily ventilation duration. Note: since the three cost categories did not sum to the total statistically derived median cost, the percentage of each category used the sum of median public + caregiver lost time + private out-of-pocket + third-party insurance as the denominator. Conclusions: For HMV children, most healthcare costs were due to family caregiving costs. More dependent children incur highest costs. The financial burden to family caregivers is substantial and needs to considered in future policy decisions related to pediatric HMV.

AB - Background: Children using home mechanical ventilation (HMV) live at home with better quality of life, despite financial burden for their family. Previous studies of healthcare utilization and costs have not considered public and private expenditures, including family caregiver time. Our objective was to examine public and private healthcare utilization and costs for children using HMV, and variables associated with highest costs. Methods: Longitudinal, prospective, observational cost analysis study (2012-2014) collecting data on public and private (out-of-pocket, third-party insurance, and caregiving) costs every 2 weeks for 6 months using the Ambulatory Home Care Record. Functional Independence Measure (FIM), WeeFIM, and Caregiving Impact Scale (CIS) were measured at baseline and study completion. Regression modeling examined a priori selected variables associated with monthly costs using Andersen and Newman's framework for healthcare utilization, relevant literature, and clinical expertise. Data are reported in 2015 Canadian dollars ($1CAD = $0.78USD). Results: Forty two children and their caregivers were enrolled. Overall median (interquartile range) monthly healthcare cost was $12 131 ($8159-$15 958) comprising $9929 (89%) family caregiving hours, $996 (9%) publicly funded, and $252 (2%) out-of-pocket (<1% third-party insurance) costs. With higher FIM score (lower dependency), median costs were reduced by 4.5% (95% confidence interval: 8.3%-0.5%), adjusted for age, sex, tracheostomy, and daily ventilation duration. Note: since the three cost categories did not sum to the total statistically derived median cost, the percentage of each category used the sum of median public + caregiver lost time + private out-of-pocket + third-party insurance as the denominator. Conclusions: For HMV children, most healthcare costs were due to family caregiving costs. More dependent children incur highest costs. The financial burden to family caregivers is substantial and needs to considered in future policy decisions related to pediatric HMV.

KW - healthcare costs

KW - healthcare utilization

KW - home mechanical ventilation

KW - long-term mechanical ventilation

KW - pediatrics

KW - ventilator assisted individual

UR - http://www.scopus.com/inward/record.url?scp=85087419609&partnerID=8YFLogxK

U2 - 10.1002/ppul.24923

DO - 10.1002/ppul.24923

M3 - Article

C2 - 32579273

AN - SCOPUS:85087419609

VL - 55

SP - 2368

EP - 2376

JO - Pediatric Pulmonology

JF - Pediatric Pulmonology

SN - 8755-6863

IS - 9

ER -

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