{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T16:30:32Z","timestamp":1758817832341},"reference-count":41,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"5","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JOP"],"published-print":{"date-parts":[[2016,5]]},"abstract":"<jats:sec><jats:title>Purpose:<\/jats:title><jats:p> State-based Medicaid programs have begun using All Patient Refined\u2013Diagnosis-Related Groups (APR-DRGs) to determine hospital reimbursement rates. Medicaid provides coverage for 45% of childhood cancer admissions. This study aimed to examine how well APR-DRGs reflect admission costs for childhood cancer chemotherapy to inform clinicians, hospitals, and policymakers in the wake of policy changes. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p> We identified 25,613 chemotherapy admissions in the 2009 Kids\u2019 Inpatient Database. To determine how well APR-DRGs explain costs, we applied a hierarchic linear regression model of hospital costs, allowing for a variety of patient, hospital, and geographic confounders. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p> APR-DRGs proved to be the most important predictors of admission costs (P &lt; .001), with costs increasing by DRG severity code. Diagnosis, age, and hospital characteristics also predicted costs above and beyond those explained by APR-DRGs. Compared with admissions for patients with acute lymphoblastic leukemia, costs of admissions for patients with acute myelomonocytic leukemia were 82% higher; non-Hodgkin lymphoma, 20% higher; Hodgkin lymphoma, 25% lower; and CNS tumors, 27% lower. Admissions for children who were 10 years of age or older cost 26% to 35% more than admissions for infants. Admissions to children\u2019s hospitals cost 46% more than admissions to other hospital types. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion:<\/jats:title><jats:p> APR-DRGs developed for adults are applicable to childhood cancer chemotherapy but should be refined to account for cancer diagnosis and patient age. Possible policy and clinical management changes merit further study to address factors not captured by APR-DRGs. <\/jats:p><\/jats:sec>","DOI":"10.1200\/jop.2015.010330","type":"journal-article","created":{"date-parts":[[2016,5,11]],"date-time":"2016-05-11T22:12:49Z","timestamp":1463004769000},"page":"e564-e575","update-policy":"http:\/\/dx.doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":10,"title":["How Well Do All Patient Refined\u2013Diagnosis-Related Groups Explain Costs of Pediatric Cancer Chemotherapy Admissions in the United States?"],"prefix":"10.1200","volume":"12","author":[{"given":"Heidi","family":"Russell","sequence":"first","affiliation":[{"name":"Baylor College of Medicine; Rice University, Houston, TX; and University of York, York, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Street","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine; Rice University, Houston, TX; and University of York, York, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vivian","family":"Ho","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine; Rice University, Houston, TX; and University of York, York, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"233","reference":[{"key":"B2","unstructured":"Florida Senate: 2011 Florida statutes 409.905 http:\/\/www.flsenate.gov\/Laws\/Statutes\/2011\/409.905"},{"key":"B3","unstructured":"Texas Medicaid & Healthcare Partnership: Hospital Services Handbook: Inpatient Reimbursement http:\/\/www.tmhp.com\/HTMLmanuals\/TMPPM\/2011\/2011TMPPM-29-081.html"},{"key":"B4","unstructured":"California Department of Health Care Services: DRG reimbursement implementation http:\/\/www.dhcs.ca.gov\/provgovpart\/Pages\/DRG-Important-Info.aspx"},{"key":"B5","unstructured":"Ohio Department of Medicaid: Hospital payment policy http:\/\/www.medicaid.ohio.gov\/PROVIDERS\/ProviderTypes\/HospitalProviderInformation\/HospitalPaymentPolicy.aspx"},{"key":"B6","unstructured":"New York Department of Health: Official compilation of the rules and regulations of the state of New York: Title 10 volume A-2\u2014Section 86-1.23: Exempt units and hospitals http:\/\/w3.health.state.ny.us\/dbspace\/NYCRR10.nsf\/0\/8525652c00680c3e8525652c006eb454?OpenDocument"},{"key":"B7","unstructured":"Illinois General Assembly: Public Act 097-0689 http:\/\/www.ilga.gov\/legislation\/publicacts\/97\/PDF\/097-0689.pdf"},{"key":"B8","volume-title":"Pediatric Cancer Hospitalizations, 2009: HCUP Statistical Brief #132","author":"Price A","year":"2012"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6947-14-88"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2013.432"},{"key":"B11","volume-title":"Introduction to the HCUP KIDS\u2019 inpatient database","author":"Healthcare Cost and Utilization Project"},{"key":"B12","unstructured":"Healthcare Cost and Utilization Project: NIS description of data elements: APRDRG\u2014All Patient Refined DRG http:\/\/www.hcup-us.ahrq.gov\/db\/vars\/aprdrg\/nisnote.jsp"},{"key":"B13","volume-title":"Cost-to-charge ratio files","author":"Healthcare Cost and Utilization Project"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/j.csda.2010.02.016"},{"key":"B15","unstructured":"US Census Bureau: Census regions and divisions of the United States http:\/\/www2.census.gov\/geo\/pdfs\/maps-data\/maps\/reference\/us_regdiv.pdf"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1002\/hec.2837"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.2307\/2951696"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhealeco.2011.05.014"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhealeco.2012.06.001"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2013.08.012"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e3181820d75"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1002\/hec.2861"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/j.breast.2012.11.001"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1159\/000346092"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1002\/hec.2842"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.5600\/mmrr.001.02.a02"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.24950"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1586\/14737167.2014.864561"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.23197"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.21184"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.24432"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.27957"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2013-01-476614"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.24420"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2011.12.008"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.23181"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21152"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.12120"},{"key":"B39","unstructured":"Children\u2019s Hospital Association: Hospital directory https:\/\/www.childrenshospitals.org\/Directories\/Hospital-Directory"},{"key":"B40","volume-title":"A Study of Hospital Charge Setting Practices","author":"Dobson A"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1186\/1478-7547-5-7"},{"key":"B42","volume-title":"Tools for More Accurate Inpatient Cost Estimates With HCUP Databases, 2009: Report #2014-04","author":"Sun Y","year":"2011"}],"container-title":["Journal of Oncology Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/JOP.2015.010330","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,25]],"date-time":"2022-05-25T22:12:42Z","timestamp":1653516762000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/JOP.2015.010330"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,5]]},"references-count":41,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2016,5]]}},"alternative-id":["10.1200\/JOP.2015.010330"],"URL":"https:\/\/doi.org\/10.1200\/jop.2015.010330","relation":{},"ISSN":["1554-7477","1935-469X"],"issn-type":[{"value":"1554-7477","type":"print"},{"value":"1935-469X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,5]]},"assertion":[{"value":"2016-04-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}