Abstract
Children with chronic health conditions require more health services than other children and are vulnerable to potential problems of access and appropriateness of care due to rapid changes in the health care system. Methods to measure hospitalization patterns of children for chronic health conditions, a measure of access and utilization, are not well-developed. The objective of this study is to identify hospitalization patterns of children with eight selected chronic health conditions, using hospital abstract reporting system data from Washington state for the ten year period 1987–1996. The methods illustrate an approach to using hospital discharge data for ongoing surveillance of children with special health care needs.
A total of 525,113 discharges representing 394,460 individual children ages 0–19 were analyzed in this study. Population-based hospitalization rate per 100,000 population, average length of stay, and rate of multiple hospitalizations per 1000 discharges, were calculated for asthma, diabetes, cystic fibrosis, muscular dystrophy, cerebral palsy, chronic respiratory disease, spina bifida, and malignant neoplasms. The hospitalization rate of 3,019.4 per 100,000 population for all causes among children 0–19 reflected a significant decline since 1987. Mean LOS of 4.9 for all causes in 1996 represented a significant decline from 5.3 in 1987. The multiple hospitalization rate for all causes increased significantly from 250.5 per 1000 discharges in 1987 to 275.5 per 1000 discharges in 1996. Condition-specific comparisons indicated an increase in hospitalization rates for asthma, chronic respiratory disease, and neoplasms, although the LOS declined for diabetes and was unchanged for all other conditions. Multiple hospitalization rates for selected conditions examined in this study did not show an increase in the ten-year period, and for diabetes, showed a statistically significant decline.
The refinements in the approach to using hospital discharge data in this study are important tools to be used for pediatric chronic disease surveillance. Further refinements should include adjustments for patient age and condition complexity, as well as stratification by payer and facility.
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Valentine, J.M., Neff, J., Park, A.N. et al. Pediatric Hospitalization Patterns for Selected Chronic Health Conditions Using Hospital Abstract Reporting System Data: Methods and Findings. Health Services & Outcomes Research Methodology 1, 335–350 (2000). https://doi.org/10.1023/A:1011459629878
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DOI: https://doi.org/10.1023/A:1011459629878