Australian study reveals the high cost of childhood hospitalization

A University of Sydney study has shed light on the impact of childhood hospitalization, showing the direct and indirect costs of pediatric admissions, how it impacts the child, their families and the health system.

This is the first study to quantify the direct costs of hospitalization, as well as the indirect and hidden costs of childhood hospitalization—including the associated emotional, financial and social toll.

The researchers are calling for increased awareness of the family-centered aspects of pediatric care and support on projects that ease the burden of childhood hospitalizations.

The study reviewed all Australian studies published between 1990 to 2022 reporting costs for pediatric hospitalization.

On average, expenses associated with loss of productivity, time taken off work to care for siblings, and incidental costs for travel, meals and accommodation could cost families more than AU$687 per admission.

There were direct costs to the hospital varies based on the reason for admission. However, it was the indirect costs that were often unaccounted for.

"This is the first time we have brought data covering all reasons for hospitalization in children to understand the costs of hospitalization along with its impact on sick kids and their families," said Dr. Eleni Demetriou from the University of Sydney's Faculty of Medicine and Health.

"The data clearly shows far reaching impact in terms of significant economic costs, the negative effect on the lives and well-being of families, as well as longer term indicators of childhood development."

The review was published in The Lancet Regional Health—Western Pacific, led by Dr. Eleni Demetriou with support by Hospitals United for Sick Kids.

Children also often showed emotional distress, fear and anxiety, which could increase stress levels and emotional exhaustion for young patients and family members. In cases of extreme distress, this could potentially impact recovery timelines.

Social and emotional costs to children and their families such as quality of life, caregiver burden, days absent from school and educational outcomes are not typically examined but were identified as crucial for the well-being of the entire family unit.

The review also highlighted the poorer educational outcomes for children with increased re-admissions and lengths of stay, linking them to results below national minimum standards on national literacy and numeracy tests.

The researchers also found the negative impact of hospitalization also seemed to be greatest for those from disadvantaged financial backgrounds, regional and rural communities, and Indigenous communities.

Senior author Professor Adam Guastella from the University of Sydney Brain and Mind Center says, "The findings of this review show we must do all we can to develop coordinated hospital-wide approaches to support families during difficult times and to deliver optimal supports that protect children experiencing vulnerability associated with their hospitalization."

By examining the trends in costs and burden of pediatric hospitalizations in Australia, the findings of this study have crucial implications for the health system to help inform policy and promote the well-being of children and their families.

"This is where 'Hospitals United for Sick Kids' is changing the model of support for sick kids in hospital to focus on where and how they can receive the best care with the least amount of disruption to their home life. If we can get a sick child out of hospital and back to the things they love sooner, we will have achieved our objective," says Nicky Bowie, GM, Hospitals United for Sick Kids.

"Thanks to our corporate partners, we have been able to invest in 71 projects over the past four years which have positively impacted the lives of more than 430,000 children. These projects have improved health outcomes, reduced the disruption caused by hospitalization on a child and their family, and substantially lowered the impact on the health care system."