Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Sep 18:40:100878.
doi: 10.1016/j.lanwpc.2023.100878. eCollection 2023 Nov.

Burden of paediatric hospitalisations to the health care system, child and family: a systematic review of Australian studies (1990-2022)

Eleni Andrea Demetriou  1 , Kelsie Ann Boulton  1 , Rinku Thapa  1 , Carter Sun  1 , John Gilroy  2 , Michael Russell Bowden  3 , Adam Guastella  1
Affiliations

Burden of paediatric hospitalisations to the health care system, child and family: a systematic review of Australian studies (1990-2022)

Eleni Andrea Demetriou et al. Lancet Reg Health West Pac. .

Abstract

Background: Paediatric hospitalisations represent a significant cost to the health system and cause significant burden to children and their families. Understanding trends in hospitalisation costs can assist with health planning and support strategies across stakeholders. The objective of this systematic review is to examine the trends in costs and burden of paediatric hospitalisations in Australia to help inform policy and promote the well-being of children and their families.

Methods: Electronic data sources (Embase, Medline, Web of Science, PSYCH-Info, CINAHL and Scopus) were searched from 1990 until December 2022. Any quantitative or qualitative studies conducted in Australian tertiary hospitals were included in the review. Eligible studies were those that included paediatric (<18 years) hospitalisations and reported on economic and/or non-economic costs for the child, family unit and/or health system. Study quality and risk of bias for each study were assessed with the Joanna Briggs Critical Appraisal Tools. We present a summary of the findings of the hospitalisation burden across major diagnostic admission categories and for the child and family unit. The systematic review was registered with Prospero (ID: CRD42021276202).

Findings: The review summarises a total of 88 studies published between 1990 and December 2022. Overall, the studies identified that paediatric hospitalisations incur significant financial costs, which have not shown significant reductions over time. In-patient direct hospital costs varied depending on the type of treatment and diagnostic condition. The costs per-case were found to range from just below AUD$2000 to AUD$20,000 or more. The financial burden on the family unit included loss of productivity, transport and travel costs. Some studies reported estimates of these costs upward of AUD$500 per day. Studies evaluating 'hospital in the home' options identified significant benefits in reducing hospitalisations and costs without compromising care.

Interpretation: Increasing focus on alternative models of care may help alleviate the significant costs associated with paediatric hospitalisation.

Funding: This research was supported by Hospitals United for Sick Kids (formerly Curing Homesickness).

Keywords: Adolescent; Burden of disease; Caregiver; Child; Hospitalisation.

PubMed Disclaimer

Conflict of interest statement

We declare no competing interests.

Figures

Fig. 1
Fig. 1
Geographical distribution of studies.
Fig. 2
Fig. 2
Percentage of studies by diagnostic category.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Srivastava R., Downie J., Hall J., Reynolds G. Costs of children with medical complexity in Australian public hospitals. J Paediatr Child Health. 2016;52(5):566–571. - PubMed
    1. Kaiser S.V., Rodean J., Coon E.R., Mahant S., Gill P.J., Leyenaar J.K. Common diagnoses and costs in pediatric hospitalization in the US. JAMA Pediatr. 2022;176(3):316–318. - PMC - PubMed
    1. Australia's health 2022. Australian Institute of Health and Welfare; 2022.
    1. Lystad R.P., Bierbaum M., Curtis K., Braithwaite J., Mitchell R. Unwarranted clinical variation in the care of children and young people hospitalised for injury: a population-based cohort study. Injury. 2018;49(10):1781–1786. - PubMed
    1. Bryant P.A., Lawrence J., Boyce S., et al. Hospital bed replacement for acute care of children at home during the COVID-19 pandemic through a hospital-in-the-home programme. Arch Dis Child. 2023;108(7):e11. - PubMed

LinkOut - more resources