Children's healthcare spending rises despite drop in doctor's visits, prescriptions, report finds
In 2010, the average price of a surgical admission for a child was $35,423, and by 2014 it was $53,372 -- a more than 50 percent increase.
Despite an overall drop in doctor's visits, emergency visits and hospital care, children's healthcare spending rose in 2014, according to a new report by the Health Care Cost Institute that claims rising prices bridged the gap in utilization.
The drop in children's use of medical care, as well as lower prescription drug use, particularly for anti-infective drugs such as penicillin among younger children and babies, is a relatively new trend, HCCI said.
Per capita spending on healthcare for children covered by employer-sponsored insurance grew an annual average of 5.1 percent per year between 2010 and 2014, reaching $2,660 in 2014, according to the HCCI report. At the same time, there was a general decline in the use of healthcare services between 2012 and 2014.
[Also: Prices for healthcare vary widely across states, even nearby cities]
Out-of-pocket spending on children increased an average annual 5.5 percent, to $472 in 2014. This growth was due in part to higher out-of-pocket spending on ER visits, which increased an average annual 11.7 percent, or $21 per capita.
The findings come after a May study done by the Urban Institute that found children's insurance coverage in 2014 soared over the previous year's numbers. Participation in Medicaid and the Children's Health Insurance Program, or CHIP, increased over that time, while the uninsured rate for children in 2014 dropped in both states that had expanded Medicaid and those that didn't, though numbers were greater for the former.
For the first time, HCCI examined children's healthcare spending trends at the state level, reporting on Arizona, Connecticut, Florida, Illinois, Maryland, Ohio, Texas, Virginia and Wisconsin, as well as the District of Columbia. Among the states studied, Arizona had the lowest per capita spending, $2,151 per child in 2014, while Wisconsin had higher per capita and out-of-pocket spending than the national average in every year studied, reaching $3,017 per capita in 2014, and $577 in out-of-pocket costs.
[Also: Affordable Care Act helps bolster ranks of insured lower-income children]
In 2014, Washington D.C. had the highest rate of spending at $3,040 per capita, but lowest out-of-pocket payments at $362. High spending in D.C. was in part driven by an increase in the number of hospital admissions for sick newborns. Additionally, D.C. had the most emergency room visits as compared to the other states examined.
"The decline in children's use of healthcare services is a relatively new trend that we need to continue monitoring," said HCCI Senior Researcher Amanda Frost in a statement. "While we know that prices have fueled much of the spending growth in 2014, future research should examine whether these higher expenditures are leading to better healthcare outcomes for children."
The report contained a number of other findings. Prices for brand prescriptions more than doubled, for instance; between 2010 and 2014, the average price for brand prescriptions shot up from $7 per day in 2010 to $16 per day in 2014. As observed among other healthcare services, increases in spending were driven by the rise in the average price per day of a brand prescription, rather than use. In 2014, per capita spending for brand prescriptions rose 6.8 percent, the fastest spending growth rate for any service category that year. For generic prescriptions, the average price per day remained stable at $2 across all years studied.
Prices also rose for surgical admissions, which was one influence on the increase in spending on acute inpatient admissions over the study period. In 2010, the average price of a surgical admission for a child was $35,423, and by 2014 it was $53,372 -- a more than 50 percent increase.
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Meanwhile, emergency room prices climbed while usage dropped. Emergency room visits comprised 8 percent of total healthcare spending per capita for children in 2014. Spending increased from $165 per capita in 2010 to $214 in 2014. The average price of an ER visit increased by $298 between 2010 and 2014. At the same time, the number of ER visits dropped from 181 emergency room visits per 1,000 children in 2010 to 177 in 2014.
The report also found that going to the doctor was the most widely used healthcare service for children; in 2014, there were 3,228 doctor visits per 1,000 children, down slightly from the previous year. Doctor visits accounted for 12 percent of the total per capita spending in 2014, at $339 per child, and was the largest share of healthcare spending for the average child.
Twitter: @JELagasse
