Publications
Publications
- NEJM Catalyst Innovations in Care Delivery
Costs Without Value When Treating Pediatric Behavioral Patients in the ED
By: Marcella Jewell, Syed S. Shehab, Robert S. Kaplan, Jack Fanton and Joeli Hettler
Abstract
Pediatric Emergency Department (ED) visits have greatly increased in recent years. An academic pediatric ED that annually treats about 1,000 behavioral health patients conducted a study to assess the true cost of caring for nonacute behavioral health patients. It learned that the hospital’s traditional costing system failed to recognize the cost of many unreimbursed or undocumented care activities. The study applied time-driven activity-based costing to capture these hidden costs as well as the actual costs of reimbursed services. It documented a cost of $219 per hour to care for a behavioral health patient in the pediatric ED, with little to no value for the patient during most of the time spent in the ED. This article describes the underlying reasons for such low-value care and potential solutions to overcome the regulatory burdens and bottlenecks that cause expensive and sub-optimal care in a pediatric ED setting.
Keywords
Citation
Jewell, Marcella, Syed S. Shehab, Robert S. Kaplan, Jack Fanton, and Joeli Hettler. "Costs Without Value When Treating Pediatric Behavioral Patients in the ED." NEJM Catalyst Innovations in Care Delivery 3, no. 2 (February 2022).