Service Delivery

Cost of hospitalization and length of stay in people with Down syndrome: evidence from a national hospital discharge claims database.

Hung et al. (2011) · Research in developmental disabilities 2011
★ The Verdict

National data show Down syndrome brings triple the inpatient cost—build that into service plans.

✓ Read this if BCBAs who coordinate medical care for teens or adults with Down syndrome.
✗ Skip if Clinicians who only serve clients without medical complexity.

01Research in Context

01

What this study did

Hung et al. (2011) pulled every hospital bill in Taiwan. They compared people who have Down syndrome with everyone else. The team counted how many nights people stayed and how much money was billed.

02

What they found

Down syndrome meant triple the hospital bill and double the nights. Average stay was 22 days, not 11. Average cost was 143 257 NT dollars, not 50 000.

03

How this fits with other research

Hsu et al. (2012) used the same Taiwan database. They saw the same pattern in older adults with intellectual disability: more visits, higher bills.

Akobirshoev et al. (2020) looked at U.S. hospital data for adults with autism. They found a darker side: longer stays plus higher death risk. The cost picture matches; the danger is new.

Poppes et al. (2010) tracked where adults with Down syndrome end up. They move more often and enter nursing homes sooner. High hospital use is one reason why.

04

Why it matters

When you plan care for a client with Down syndrome, budget for twice the hospital time. Schedule extra days for medical leaves, and prep families for bigger bills. Use the data to ask doctors for shorter-stay plans when safe.

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→ Action — try this Monday

Add a line in the care plan that anticipates twice the normal hospital stay time.

02At a glance

Intervention
not applicable
Design
other
Sample size
375
Population
down syndrome
Finding
not reported

03Original abstract

The present paper aims to describe the hospitalization profiles which include medical expenses and length of stays, and to determine their possible influencing factors of hospital admission on persons with Down syndrome in Taiwan. We employed a population-based, retrospective analyses used national health insurance hospital discharge data of the year 2005 in this study. Subject inclusion criteria included residents of Taiwan, and diagnosed with Down syndrome (ICD code is 758.0; N=375). Inpatient records included personal characteristics, admissions, length of stay, and medical expenses of study subjects. The results found that Down syndrome patients used 2 hospital admissions and their annual length of stay in hospital was 22.26 days, and the mean medical cost of admissions was 143,257 NT$. The admission figures show that Down syndrome individuals used two times of hospital days and nearly three times of medical expenses comparing to the general population in Taiwan. Finally, the multiple regression models revealed that factors of age, hold a serious illness card, low income family member, frequency of hospital admission, high medical expense user were more likely to use longer inpatient days (R2=0.36). Annual inpatient expense of people with Down syndrome was significantly affected by factors of severe illness card holder, low income family member, frequency of hospital admission and longer hospital stays (R2=0.288). Based on these findings, we suggest the further study should focus on the effects of medical problems among persons with Down syndrome admitted for hospital care is needed.

Research in developmental disabilities, 2011 · doi:10.1016/j.ridd.2011.02.024