Pediatric carve outs: the use of disease-specific conditions as risk adjusters in capitated payment systems

Article Abstract:

It appears possible to develop a list of specific pediatric diseases that can be considered for separate reimbursement. Such a list could make reimbursement under capitated plans more equitable. Researchers analyzed 1993 Washington State Medicaid cost data for 300,000 children to determine whether certain diseases had high costs, low cost variability, and accounted for a large percentage of overall spending. They found that 673 children or 2 per 1,000 generated annual costs of $25,000 or more. They fell into the categories of prematurity, complications of prematurity, cancer, congenital heart disease, organ transplantations, congenital anomalies, and respiratory problems.

Research, Capitated payment systems (Medical care), Risk (Insurance)

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Tobacco and children: an economic evaluation of the medical effects of parental smoking

Article Abstract:

Exposure to tobacco smoke may cause significant illness in children, with annual medical costs that may approach $5 billion. Researchers studied the impact of parental and other passive smoking on children by reviewing medical and government literature from 1980 to 1996. Exposure to smoke may cause additional cases of low birth weight, respiratory and ear infections, asthma, injury, and more than 6,200 deaths in children every year. Tobacco smoke is a preventable source of illness and injury in children. Efforts to curtail parental smoking could reduce pediatric medical expenditures.

Health aspects, Medical care, Cost of, Health care costs, Passive smoking

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Are Signs and Symptoms Associated With Persistent Corneal Abrasions in Children?

Article Abstract:

Many children with corneal abrasions have no symptoms so careful follow-up is needed even after treatment of existing corneal abrasions. This was the conclusion of researchers who examined 77 children who had previously been treated for corneal abrasion. Pain, light sensitivity, redness, and pain and redness combined were not very accurate in detecting those who still had corneal abrasion. Of 26 who still had corneal abrasion, six had no symptoms and 15 had only redness.

Diagnosis, Corneal diseases

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