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High Cost of Home Respiratory Equipment, Supply Use

J Pediatr; ePub 2019 Jan 4; Berry, Goodman, et al

The use of respiratory medical equipment and supplies (RMES) is associated with high health care spending, especially with hospital and home health care, a recent study found. Therefore, population health initiatives in children may benefit from consideration of RMES in comprehensive risk assessment for health care spending. Researchers conducted a cohort study of 20,352 children aged 1-18 years continuously enrolled in Medicaid in 2013 from 12 states; 7,060 children using RMES were propensity score matched with 13,292 without RMES. Home RMES use was identified with Healthcare Common Procedure Coding System and International Classification of Diseases codes. They found:

  • Of children requiring RMES, 47% used oxygen, 28% suction, 22% noninvasive positive-pressure ventilation, 17% tracheostomy, 8% ventilator, 5% mechanical in-exsufflator, and 4% high-frequency chest wall oscillator.
  • Most children (93%) using RMES had a chronic condition; 26% had ≥6.
  • The median per-member-per-year payments in matched children with vs without RMES were $24,359 vs $13,949.
  • In adjusted analyses, payment increased significantly with mechanical in-exsufflator (+$2,657), tracheostomy (+$6,447), suction (+$7,341), chest wall oscillator (+$8,925), and ventilator (+$20,530).

Berry JG, Goodman DM, Coller RJ, et al. Association of home respiratory equipment and supply use with health care resource utilization in children. [Published online ahead of print January 4, 2019]. J Pediatr. doi:10.1016/j.jpeds.2018.11.046.