New Findings from Stanford University in the Area of Insurance Described (Determination of Highly Resource-Intensive Pediatric Patients: Opportunity for Innovation): Insurance

2025 DEC 01 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Research findings on Insurance are discussed in a new report. According to news reporting out of Stanford, California, by NewsRx editors, research stated, “To assess the most resource-intensive diagnosis-related groups in children’s hospitals and determine the associated patient outcomes and payor distribution patterns. This retrospective cohort study analyzed 359,616 pediatric inpatient encounters across 39 tertiary-care children’s hospitals using the Pediatric Health Information System database from January-December 2023.”

Our news journalists obtained a quote from the research from Stanford University, “After excluding encounters primarily for physical therapy, pain management, diagnostic services, and routine primary care services, resource-intensive care was identified by evaluating length of stay, billed charges, and cost-to-charge ratios. The top twenty diagnosis-related groups for each metric were classified as most resource-intensive. Secondary outcomes included clinical complications and payor patterns. The cohort (median age 4.0 years; 52.8% male) showed resource-intensive diagnosis groups were predominantly perinatal syndromes (57.5%), followed by oncologic conditions (5.8%) and musculoskeletal disorders (4.4%). Resource-intensive encounters demonstrated significantly higher rates of complex chronic conditions (72%-94% vs 52% overall; P<0.001) and complications (both medical and surgical) compared with the general population. Children’s Health Insurance Program-covered patients (relative risk [RR] =1.39 [95% CI 1.23-1.59]) and those with commercial preferred provider organization insurance (RR=1.09 [95% CI 1.03-1.14]) had higher risks of resource-intensive care, yet Medicaid Managed Care and commercial health maintenance organization plans (both RR=0.89, P<0.001) had protective effects. Perinatal syndromes, oncologic conditions, and musculoskeletal disorders were the most resource-intensive pediatric diagnoses, with significantly higher complication rates than the general inpatient population.”

According to the news editors, the research concluded: “Insurance type was associated with resource utilization, suggesting targeted care management for high-resource diagnoses could improve the value of pediatric hospital care.”

This research has been peer-reviewed.

For more information on this research see: Determination of Highly Resource-Intensive Pediatric Patients: Opportunity for Innovation. The Journal of Pediatrics, 2025:114899. The Journal of Pediatrics can be contacted at: Mosby-elsevier, 360 Park Avenue South, New York, NY 10010-1710, USA.

Our news journalists report that additional information may be obtained by contacting Juliana Perl, Stanford Mussallem Center for Biodesign, Stanford University, Stanford, California, United States. Additional authors for this research include Josiah Yarbrough and Kunj Sheth.

Publisher contact information for the The Journal of Pediatrics is: Mosby-elsevier, 360 Park Avenue South, New York, NY 10010-1710, USA.

(Our reports deliver fact-based news of research and discoveries from around the world.)