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Healthcare spending for children sees sharp increase, accounts for 8.4% of total healthcare spend

Spending levels on children have swelled more than $83 billion in the last two decades, AMA pediatrics journal says.

Jeff Lagasse, Associate Editor

New figures revealed in the Journal of the American Medical Association's Pediatrics publication show healthcare spending on children has spiked more than 50 percent in the last two decades. While spending levels on children were at about $150 billion in 1996, by 2013 that number had swelled to $233.5 billion, a 56.2 percent increase. Per child, that represents annualized growth of 2.5 percent.

Overall, children's healthcare spending accounted for 8.4 percent of total healthcare spending in 2013, the research found.

The largest health condition leading to healthcare spending for children was well-newborn care in the inpatient setting, with $27.9 billion spent on infants younger than 1 year. Attention-deficit/hyperactivity disorder and well-dental care (including dental check-ups and orthodontia) were the second and third largest conditions, respectively, the research showed.

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[Also: Children's hospitals trail in revenue growth, but generate stronger margins, Moody's says]

In fact, a full 78 percent of all personal healthcare spending on children was accounted for by 20 costly conditions. Of the $20.6 billion spent on ADHD, more than 60 percent was spent on boys 5- to 14-years-old.

Broken down by age, infants younger than 1 year accounted for much more of the spending than other age groups, at almost $12,000 per child. Of that spending, almost 80 percent took place in inpatient facilities. Of inpatient care spending, more than 69 percent was spent on well-newborn care, while only about 15 percent was spent on neonatal conditions. The remaining age groups each received roughly 15 to 25 percent of the amount spent on infants younger than 1 year, and most of that spending was for ambulatory care rather than inpatient care.

Healthcare spending on 15- to 19-year-old adolescents was spurred by reproductive health spending, including pregnancy and postpartum care, maternal conditions and family planning. About $350 per girl in this age group was spent on pregnancy and postpartum care. Following a decline in adolescent pregnancy since 2008, inpatient spending on pregnancy and postpartum care for these girls dropped slightly from 2008 through 2013, the only area to see a decline.

[Also: Children, toddlers flood hospital emergency rooms due to opioid poisoning, study finds]

Despite the modest reductions, though, pregnancy and postpartum care remains the largest condition leading to health care spending for girls in that age group, and the 19th largest condition across all ages and sexes.

While the research pinpoints areas in which spending has increased, it does not examine whether the increases have been accompanied by better outcomes. Determining that, the authors said, should be the next step, and would make fertile ground for future research. It's crucial, they said, to understand whether the increases are appropriate or misguided, and to determine where spending increases and reductions should be targeted.

Twitter: @JELagasse