Evaluation of a Cash Transfer for Behaviour Change in Pregnancy: A Natural Experiment of Routine Data in Scotland 2004-13

Purpose: The epidemiology of hospitalization for pediatric brain tumors (PBT) in the United States has not been reported recently. We examined trends and outcomes associated with admission for PBT at the national level across 10 years. Methods: All patients 18 years of age with PBT were identified in the Nationwide Inpatient Sample from 2001-2010 and hospitalization trends and patient outcomes were examined. Results: A total of 137,500 PBT admissions were identified; most occurred among younger patients: 33.9% were 0-4years, 27.0% 5-9years, 22.9% 1014years, and 16.2% 15-18years of age. Overall, 55.3% of patients were male. Private insurance was the predominant payer (58.8%) followed by Medicaid (34.3%); 6.9% of patients had other/unknown coverage. Admissions were centered in teaching hospitals (90.8%) and urban areas (96.3%). Most tumors were malignant (85.5%) with similar proportions classified as benign (7.4%) and undetermined (7.1%). Patients with malignancies were younger than those with benign disease (7.5 vs.11.4 years, p<0.001). Overall, 25.4% of patients underwent neurosurgical intervention (60.7% for benign vs. 20.3% for malignant tumors, p<0.001). Inpatient mortality was stable across time at approximately 1.9%, but was lower among patients treated surgically (0.96%) vs. those without surgery (2.2%) (p<0.001). Mean hospitalization was 6.7 days, and hospital charges averaged $41,733 (95%CI $39,231-$44,235). Aggregated annual inpatient charges for treatment of PBT were $1,101,545,208 in 2010. Conclusion: Pediatric brain tumors constitute a significant healthcare burden. Inpatient mortality has remained stable over the past decade; however, death was more common among patients with malignant tumors and those for whom surgery was not indicated/performed.