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Cited by 108Health Systems, Economic Evaluations, Quality of LifeHealthcare Policy and ManagementPediatric Pain Management Techniques

Health-related quality of life as a predictor of pediatric healthcare costs: A two-year prospective cohort analysis

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Seid, Michael, Varni, James W, Segall, Darron, Kurtin, Paul S·2004·Health and Quality of Life Outcomes
DOI 10.1186/1477-7525-2-48PMC PMC521194
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Abstract

Background: The objective of this study was to test the primary hypothesis that parent proxy-report of pediatric health-related quality of life (HRQL) would prospectively predict pediatric healthcare costs over a two-year period. The exploratory hypothesis tested anticipated that a relatively small group of children would account for a disproportionately large percent of healthcare costs. Methods: 317 children (157 girls) ages 2 to 18 years, members of a managed care health plan with prospective payment participated in a two-year prospective longitudinal study. At Time 1, parents reported child HRQL using the Pediatric Quality of Life Inventory™ (PedsQL™ 4.0) Generic Core Scales, and chronic health condition status. Costs, based on health plan utilization claims and encounters, were derived for 6, 12, and 24 months. Results: In multiple linear regression equations, Time 1 parent proxy-reported HRQL prospectively accounted for significant variance in healthcare costs at 6, 12, and 24 months. Adjusted regression models that included both HRQL scores and chronic health condition status accounted for 10.1%, 14.4%, and 21.2% of the variance in healthcare costs at 6, 12, and 24 months. Parent proxy-reported HRQL and chronic health condition status together defined a 'high risk' group, constituting 8.7% of the sample and accounting for 37.4%, 59.2%, and 62% of healthcare costs at 6, 12, and 24 months. The high risk group's per member per month healthcare costs were, on average, 12 times that of other enrollees' at 24 months. Conclusions: While these findings should be further tested in a larger sample, our data suggest that parent proxy-reported HRQL can be used to prospectively predict healthcare costs. When combined with chronic health condition status, parent proxy-reported HRQL can identify an at risk group of children as candidates for proactive care coordination.

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  1. Starfield B Riley AW BF Green Ensminger ME Ryan SA Kelleher K et al. The adolescent CHIP: A population-based measure of health Medical Care 1995 33 553 566 7739277

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Authors
Seid, M., Varni, J. W., Segall, D., & Kurtin, P. S.
Affiliations
  • RAND Corporation (US)
  • Texas A&M University System (US)
Corresponding author
Seid, Michael
ORCID
Venue
Health and Quality of Life Outcomes
Publisher
Springer Science and Business Media LLC
Published
2004-09-10
Volume
2
Issue
1
Pages
48-48
ISSN
1477-7525 (ISSN-L)
DOI
10.1186/1477-7525-2-48
PMC
PMC521194
OpenAlex
W2118612528
Cited by
108
References
49
Citations by year
2026: 3 · 2025: 2 · 2024: 6 · 2023: 1 · 2022: 2 · 2021: 3 · 2020: 3 · 2019: 4 · 2018: 3 · 2017: 2 · 2016: 5 · 2015: 8 · 2014: 6 · 2013: 8 · 2012: 6
FWCI
10.33
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Health and Quality of Life Outcomes (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
Keywords
health-related quality of life, parent proxy reporting, PedsQL 4.0, chronic disease, managed care, prospective payment, care coordination, children
MeSH terms
Adolescent, California, Child, Child Health Services, Child Welfare, Child, Preschool, Chronic Disease, Female, Health Status, Humans, Longitudinal Studies, Male, Managed Care Programs, Medicaid, Parents, Pediatrics, Psychometrics, Quality of Life, Health Care Costs, Sickness Impact Profile, Risk Assessment, Proxy, Children with Disabilities, Disabled Children

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