{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T04:51:21Z","timestamp":1764305481309,"version":"3.40.5"},"reference-count":10,"publisher":"American Academy of Pediatrics (AAP)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,10,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVES:<\/jats:title>\n                  <jats:p>Hospitalizations for child maltreatment cases are longer and costlier than hospitalizations for medically similar nonabuse cases. Some discharges are delayed despite medical clearance because of a lack of safe disposition, increasing the cost of hospitalization. We aim to quantify the additional charges and costs of these delays.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>A retrospective chart review evaluated the dates of medical clearance and clinical characteristics of child protection team inpatient consults from 2012 to 2014 at a 595-bed quaternary-care urban hospital. Charges and costs were compared between those with no delay, those with any delay, and those with a delay &amp;gt;1 day. We excluded children who were not admitted, in whom no abuse was suspected, or in whom sexual abuse was suspected absent extragenital injury.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>Thirty-six percent (134 of 375) of children hospitalized for abuse remained hospitalized after medical clearance and 20.5% (77 of 375) of children were delayed &amp;gt;1 day. Among those who were delayed, the mean number of days delayed was 4.37 (SD \u00b17.44). Mean charges after medical clearance were $13\u2009647.53 (\u00b1$30\u2009172.17), and mean costs after medical clearance were $6521.93 (\u00b1$13\u2009975.34). Both charges and costs were markedly right-skewed. Median costs after medical clearance were $1553.64 (interquartile range, $26.10\u2013$5244.20). Cumulatively, 586 total days of delay resulted in excess charges of $1.8 million.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>Continued hospitalization beyond medical clearance occurs often and represents a significant cost. Further study is needed to evaluate whether interventions can be targeted at children with characteristics correlated with prolonged discharge delays.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/hpeds.2017-0027","type":"journal-article","created":{"date-parts":[[2017,10,2]],"date-time":"2017-10-02T08:41:06Z","timestamp":1506933666000},"page":"572-578","source":"Crossref","is-referenced-by-count":12,"title":["Hospital Costs and Charges of Discharge Delays in Children Hospitalized for Abuse and Neglect"],"prefix":"10.1542","volume":"7","author":[{"suffix":"Jr","given":"Michael","family":"Lee","sequence":"first","affiliation":[{"name":"Division of Emergency Medicine, Boston Children\u2019s Hospital, Boston, Massachusetts;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela","family":"Bachim","sequence":"additional","affiliation":[{"name":"Sections of Public Health Pediatrics and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolyn","family":"Smith","sequence":"additional","affiliation":[{"name":"Decision Support and Cost Accounting, Texas Children's Hospital, Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth A.","family":"Camp","sequence":"additional","affiliation":[{"name":"Emergency Medicine, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcella","family":"Donaruma-Kwoh","sequence":"additional","affiliation":[{"name":"Sections of Public Health Pediatrics and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Binita","family":"Patel","sequence":"additional","affiliation":[{"name":"Emergency Medicine, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2017,10,1]]},"reference":[{"issue":"2","key":"2021120817212208600_B1","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1542\/peds.2012-2212","article-title":"Health care costs associated with child maltreatment: impact on Medicaid","volume":"132","author":"Florence","year":"2013","journal-title":"Pediatrics"},{"author":"US Department of Health & Human Services","key":"2021120817212208600_B2"},{"issue":"5","key":"2021120817212208600_B3","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1016\/j.chiabu.2009.09.014","article-title":"The economic impact of child maltreatment in the United States: are the estimates credible?","volume":"34","author":"Corso","year":"2010","journal-title":"Child Abuse Negl"},{"issue":"4","key":"2021120817212208600_B4","doi-asserted-by":"crossref","first-page":"586","DOI":"10.2105\/AJPH.94.4.586","article-title":"The economic burden of hospitalizations associated with child abuse and neglect","volume":"94","author":"Rovi","year":"2004","journal-title":"Am J Public Health"},{"issue":"7","key":"2021120817212208600_B5","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1016\/j.chiabu.2005.12.006","article-title":"The need for economic analysis in research on child maltreatment","volume":"30","author":"Corso","year":"2006","journal-title":"Child Abuse Negl"},{"issue":"2","key":"2021120817212208600_B6","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1016\/j.chiabu.2011.10.006","article-title":"The economic burden of child maltreatment in the United States and implications for prevention","volume":"36","author":"Fang","year":"2012","journal-title":"Child Abuse Negl"},{"issue":"8","key":"2021120817212208600_B7","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1016\/S0145-2134(97)00036-7","article-title":"Outcome and cost of child abuse","volume":"21","author":"Irazuzta","year":"1997","journal-title":"Child Abuse Negl"},{"issue":"8","key":"2021120817212208600_B8","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1016\/S0145-2134(00)00163-0","article-title":"Child maltreatment related injuries: incidence, hospital charges, and correlates of hospitalization","volume":"24","author":"Forjuoh","year":"2000","journal-title":"Child Abuse Negl"},{"issue":"10","key":"2021120817212208600_B9","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.1016\/j.chiabu.2004.06.006","article-title":"Abusive head trauma in young children: characteristics and medical charges in a hospitalized population","volume":"28","author":"Ettaro","year":"2004","journal-title":"Child Abuse Negl"},{"issue":"4","key":"2021120817212208600_B10","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1016\/j.acap.2015.01.008","article-title":"The accuracy of ICD codes: identifying physical abuse in 4 children\u2019s hospitals","volume":"15","author":"Hooft","year":"2015","journal-title":"Acad Pediatr"}],"container-title":["Hospital Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/hospitalpediatrics\/article-pdf\/7\/10\/572\/813881\/hpeds_2017-0027.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/hospitalpediatrics\/article-pdf\/7\/10\/572\/813881\/hpeds_2017-0027.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,8]],"date-time":"2021-12-08T17:49:25Z","timestamp":1638985765000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/hospitalpediatrics\/article\/7\/10\/572\/26421\/Hospital-Costs-and-Charges-of-Discharge-Delays-in"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,10,1]]},"references-count":10,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2017,10,1]]},"published-print":{"date-parts":[[2017,10,1]]}},"URL":"https:\/\/doi.org\/10.1542\/hpeds.2017-0027","relation":{},"ISSN":["2154-1663","2154-1671"],"issn-type":[{"type":"print","value":"2154-1663"},{"type":"electronic","value":"2154-1671"}],"subject":[],"published":{"date-parts":[[2017,10,1]]}}}