Real-World Evidence on Hospitalization Costs of Pediatric Neoplasm Patients in China: Patterns, Trends, and Associated Factors From a Retrospective Cohort Study.
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BACKGROUND: In China, the incidence and burden of pediatric neoplasms have been increasing, contributing to escalating healthcare expenditures and productivity losses, with hospitalization costs constituting a major component of the economic burden. However, evidence on the full spectrum of neoplasm-related hospitalization costs for pediatric patients remains limited, particularly from real-world longitudinal studies. METHODS: This retrospective multicenter cohort study (2017-2023) analyzed pediatric hospitalization data in Shanghai by integrating data from two administrative databases. The study included all children aged ≤ 18 years hospitalized with ICD-10-coded benign and malignant neoplasms and related complications. Hospitalization costs were discounted to 2023 values, converted to US dollars, and analyzed using descriptive statistics and generalized linear models (GLMs) to identify influencing factors, including socioeconomic, clinical, and hospital-related variables. RESULTS: Among 688,131 pediatric hospitalizations, 13,057 (1.91%) were for neoplasms. Neoplasm patients had significantly higher care intensity and hospitalization costs than nonneoplasm patients, with malignant neoplasms incurring the highest median costs. From 2017 to 2023, total costs for neoplasm patients declined by 26.88%, driven by a 52.87% reduction in drug costs, contrasting with rising costs for nonneoplasm patients. Leukemia was the most prevalent condition, while some rare but high-cost entities, such as secondary malignant neoplasms of the respiratory and digestive organs, were among the most expensive. GLM analysis identified sex, insurance type, pathology, surgical interventions, length of stay, and hospital characteristics as significant cost drivers. CONCLUSION: This study provides comprehensive evidence on hospitalization cost patterns, trends, and influencing factors for pediatric neoplasms. It highlights the need for enhanced insurance coverage, early diagnosis and treatment, and equitable resource allocation to reduce disparities.