TABLE 3

Health Expenditures and Utilization Among CSHCN by SDM Group

All CSHCNSDM IncreasingSDM Unchanged HighSDM Unchanged LowSDM Decreasing
Sample N28584831443484448
No. children represented in population12.0 million1.9 million6.3 million2.0 million1.8 million
Percent represented100.0%15.9%51.9%17.0%15.2%
Mean total health expendituresa:
 in year 1b21312050211122222178
 in year 220711711203322042423
 change (95% CI)c−60 (−202, 82)−339 (−660, −21)−78 (−260, 104)−18 (−459, 422)245 (−181, 672)
Mean out-of-pocket expendituresa:
 in year 1b389398396392351
 in year 2374333384334428
 change (95% CI)c−15 (−46, 17)−65 (−150, 21)−12 (−58, 34)−58 (−133, 17)77 (−12, 166)
Mean office-based expendituresa:
 in year 1b557521544645538
 in year 2537452541566576
 change (95% CI)c−20 (−60, 20)−69 (−146, 8)−3 (−53, 47)−79 (−193, 34)38 (−80, 157)
Mean inpatient expendituresa:
 in year 1b127133107140173
 in year 213085120204126
 change (95% CI)c3 (−35, 38)−48 (−130, 34)13 (−34, 60)64 (−41, 169)−47 (−135, 42)
Mean ED expendituresa:
 in year 1b6463666059
 in year 25432624558
 change (95% CI)c−10 (−19, 1)−31 (−51, 12)−4 (−17, 10)−15 (−39, 8)−1 (−29, 28)
Mean prescription expendituresa:
 in year 1b478430505422498
 in year 2547508571511548
 change (95% CI)c69 (38, 101)78 (9, 148)66 (23, 108)89 (19, 159)50 (−30, 131)
Mean rate of hospitalizationsd:
 in year 1b6.57.55.06.810.2
 in year 25.93.55.47.97.4
 change (95% CI)c−0.6 (−2.4, 1.2)−4.0 (−7.9, −0.1)0.4 (−1.8, 2.7)1.1 (−3.4, 5.6)−2.8 (−9.0, 3.3)
Mean rate of ED visitsd:
 in year 1b27.026.124.632.330.3
 in year 222.514.823.523.925.5
 change (95% CI)c −4.5 (−7.9, -1.1)−11.3 (−18.3, −4.3)−1.1 (−5.2, 3.1)−8.4 (−18.3, 1.4)−4.8 (−15.0, 5.4)
Mean rate of office visitse:
 in year 1b6.16.36.06.45.6
 in year 26.25.16.27.46.2
 change (95% CI)c0.1 (−0.3, 0.6)−1.2 (−2.0, −0.3)0.2 (-0.4, 0.7)1.0 (−0.8, 2.9)0.6 (−0.6, 1.7)
Mean rate of prescriptionse:
 in year 1b7.87.78.07.38.0
 in year 28.07.38.47.78.1
 change (95% CI)c 0.2 (−0.1, 0.6)−0.4 (−1.1, 0.3)0.4 (−0.2, 1.0)0.4 (−0.4, 1.2)0.1 (−0.9, 1.0)
  • a The highest 2.5% of expenditure values were trimmed at the 97.5 percentile to avoid bias and ensure that assumptions of normality of the statistical models were not violated. All amounts are in US dollars ($).

  • b There were no significant baseline differences between groups with different SDM patterns for any of the outcomes (all P > .05 based on linear regression accounting for the survey design).

  • c 95% confidence intervals calculated from linear regression with robust variance estimates accounting for the weighted, clustered, and stratified MEPS survey design.

  • d Rates are per 100 patients per year.

  • e Rates are per patient per year.