{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T12:59:30Z","timestamp":1792069170762,"version":"4.4.0"},"reference-count":12,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1997,8,1]]},"abstract":"<jats:p>Objective.\u2003We calculated expenditures for children with one of eight selected chronic health conditions who were enrolled in the Washington State Medicaid program and compared them with payments for all Medicaid-enrolled children. We examined variation in mean, median, and total expenditures and identified expenditure sources.<\/jats:p>\n               <jats:p>Methods.\u2003This study analyzed Medicaid claims data for 310\u2009977 children aged 0 to 18 who were enrolled at any time in fiscal year 1993. Tracer conditions were used to examine expenditure variation within and between diagnostic groupings. A total of 18\u2009233 children (5.9%) had at least one of the conditions. Expenditures were calculated based on payments made by the Medicaid program.<\/jats:p>\n               <jats:p>Results.\u2003Children with one of the eight selected conditions incurred mean expenditures of $3800, compared with $955 for all Medicaid-enrolled children. Mean payments associated with the selected conditions ranged from 2.5 times to 20 times more than payments to all children. Approximately 10% of children accounted for approximately 70% of the payments in general and in each diagnostic grouping. Variation in mean, median, and total expenditures was extensive among the conditions. For most conditions, inpatient stays accounted for the greatest proportion of expenditures; for some conditions, durable equipment, home nursing, and medication-related services accounted for substantial proportions of total expenditures.<\/jats:p>\n               <jats:p>Conclusions.\u2003Medical care for children with selected chronic health conditions is 2.5 to 20 times more expensive than children in general, depending on the condition. A relatively few children account for the majority of expenditures. Extensive variation in mean, median, and total expenditures suggests that different conditions will need to be kept distinct for purposes of establishing payment rates. Children with certain conditions are vulnerable to restrictions in specific services, depending on what restrictions are imposed by a financing program. Further analyses are needed to identify risk-adjustment strategies to support delivery of high-quality services to this population of children as they migrate into managed-care environments.<\/jats:p>","DOI":"10.1542\/peds.100.2.197","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T23:40:17Z","timestamp":1092440417000},"page":"197-204","source":"Crossref","is-referenced-by-count":141,"title":["Expenditures for Care of Children With Chronic Illnesses Enrolled in the Washington State Medicaid Program, Fiscal Year 1993"],"prefix":"10.1542","volume":"100","author":[{"given":"Henry T.","family":"Ireys","sequence":"first","affiliation":[{"name":"From the Departments of Maternal and Child Health, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerard F.","family":"Anderson","sequence":"additional","affiliation":[{"name":"Health Policy and Management, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, Maryland; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom J.","family":"Shaffer","sequence":"additional","affiliation":[{"name":"Health Policy and Management, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, Maryland; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M.","family":"Neff","sequence":"additional","affiliation":[{"name":"Children's Hospital & Medical Center, University of Washington School of Medicine, Seattle, Washington."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[1997,8,1]]},"reference":[{"key":"2021121109453856300_B1","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1542\/peds.93.3.497","article-title":"Children with chronic illness and Medicaid managed care.","volume":"93","author":"Newacheck","year":"1994","journal-title":"Pediatrics."},{"key":"2021121109453856300_B2","doi-asserted-by":"crossref","first-page":"1468","DOI":"10.1001\/jama.1995.03530180062032","article-title":"The effect on children of curtailing Medicaid spending.","volume":"274","author":"Newacheck","year":"1995","journal-title":"JAMA"},{"key":"2021121109453856300_B3"},{"key":"2021121109453856300_B4","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1001\/jama.1995.03530060043031","article-title":"Use of health services by African-American children with asthma on Medicaid.","volume":"274","author":"Lozano","year":"1995","journal-title":"JAMA"},{"key":"2021121109453856300_B5"},{"key":"2021121109453856300_B6","first-page":"188","article-title":"Estimates of the economic expenditures of birth defects.","volume":"33","author":"Waitzman","year":"1994","journal-title":"Inquiry."},{"key":"2021121109453856300_B7"},{"key":"2021121109453856300_B8"},{"key":"2021121109453856300_B9","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1542\/peds.98.2.178","article-title":"Assuring quality of care for children with special needs in managed care organizations: roles for pediatricians.","volume":"98","author":"Ireys","year":"1996","journal-title":"Pediatrics."},{"key":"2021121109453856300_B10","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/S0022-3476(94)70252-7","article-title":"Prevalence and impact of multiple childhood chronic illnesses.","volume":"124","author":"Newacheck","year":"1994","journal-title":"J Pediatr."},{"key":"2021121109453856300_B11","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1542\/peds.98.1.10","article-title":"Capitation adjustment for pediatric populations.","volume":"98","author":"Fowler","year":"1996","journal-title":"Pediatrics."},{"key":"2021121109453856300_B12","doi-asserted-by":"crossref","first-page":"1866","DOI":"10.1001\/jama.1995.03530230052030","article-title":"Protecting children with chronic illness in a competitive marketplace.","volume":"274","author":"Neff","year":"1995","journal-title":"JAMA"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/100\/2\/197\/885196\/pe089700197o.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/100\/2\/197\/885196\/pe089700197o.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,11]],"date-time":"2021-12-11T09:45:44Z","timestamp":1639215944000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/100\/2\/197\/38925\/Expenditures-for-Care-of-Children-With-Chronic"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1997,8,1]]},"references-count":12,"journal-issue":{"issue":"2","published-online":{"date-parts":[[1997,8,1]]},"published-print":{"date-parts":[[1997,8,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.100.2.197","relation":{},"ISSN":["1098-4275","0031-4005"],"issn-type":[{"value":"1098-4275","type":"electronic"},{"value":"0031-4005","type":"print"}],"subject":[],"published":{"date-parts":[[1997,8,1]]}}}