Skip to Main Content
HBS Home
  • About
  • Academic Programs
  • Alumni
  • Faculty & Research
  • Baker Library
  • Giving
  • Harvard Business Review
  • Initiatives
  • News
  • Recruit
  • Map / Directions
Faculty & Research
  • Faculty
  • Research
  • Featured Topics
  • Academic Units
  • …→
  • Harvard Business School→
  • Faculty & Research→
Publications
Publications
  • Article
  • 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
  • Format:Electronic
ShareBar

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

Costs; Value; Healthcare; Health Care and Treatment; Cost Management

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).
  • Find it at Harvard
  • Purchase

About The Author

Robert S. Kaplan

Accounting and Management
→More Publications

More from the Authors

    • January 2023
    • Faculty Research

    Performance Management at Afreximbank

    By: Robert S. Kaplan and Siko Sikochi
    • January 2023
    • Faculty Research

    Brigham & Women's Hospital: Using Patient Reported Outcomes to Improve Breast Cancer Care

    By: Robert S. Kaplan
    • December 2022
    • Wisconsin Medical Journal

    Collaborative Rooming: An Innovative Pilot Project to Overcome Primary Care Challenges

    By: Gagandeep Singh, Jill G. Lenhart, Richard A. Helmers, Michele Renee Eberlee, Heather Costley, Joel B. Roberts and Robert S. Kaplan
More from the Authors
  • Performance Management at Afreximbank By: Robert S. Kaplan and Siko Sikochi
  • Brigham & Women's Hospital: Using Patient Reported Outcomes to Improve Breast Cancer Care By: Robert S. Kaplan
  • Collaborative Rooming: An Innovative Pilot Project to Overcome Primary Care Challenges By: Gagandeep Singh, Jill G. Lenhart, Richard A. Helmers, Michele Renee Eberlee, Heather Costley, Joel B. Roberts and Robert S. Kaplan
ǁ
Campus Map
Harvard Business School
Soldiers Field
Boston, MA 02163
→Map & Directions
→More Contact Information
  • Make a Gift
  • Site Map
  • Jobs
  • Harvard University
  • Trademarks
  • Policies
  • Accessibility
  • Digital Accessibility
Copyright © President & Fellows of Harvard College