Abstract
The objective of this study was to identify pediatric conditions commonly resulting in long hospitalizations, to evaluate changes in hospital use for these conditions over a 9-year period, and to describe the characteristics of children hospitalized for long periods (longer than 7 days). To accomplish this purpose we conducted a population-based, descriptive analysis of pediatric hospitalizations for children aged 1 to 12 years in California in 1985 and 1994 using hospital discharge data. We found that hospitalizations of longer than 7 days accounted for 10.8% of pediatric hospitalizations in 1985 (58.4% of pediatric hospital days) and 11.8% of hospitalizations in 1994 (50.4% of hospital days). Rates of long pediatric hospitalization decreased from 312.1/100,000 children in 1985 to 236.4/100,000 children in 1994. Rates fell for both sexes, in all racial/ethnic groups, and among both preschool-age and school-age children. Common reasons for long hospitalizations in both 1985 and 1994 included lower-limb fractures, pneumonia, appendicitis, and malignancies. The rate of long hospitalization for mental disorders increased by 57% between 1985 and 1994, while the rate for injuries and poisoning decreased by 38%. In summary, long pediatric hospitalizations in 1985 and 1994 accounted for under 12% of all hospitalizations of children but for more than 50% of all hospital days. Although the overall rate of long pediatric hospitalizations decreased, rates for certain conditions, notably mental disorders, increased. As states continue to implement major health care changes, further study of conditions among children that account for a large proportion of hospital days is warranted.
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REFERENCES
Lewit EM, Monheit AC. Expenditures on health care for children and pregnant women. Future Child 1992; 2:95-114.
Zetterstrom R. Responses of children to hospitalization. Acta Paediatr Scand 1984 73:289-295.
Haslum MN. Length of preschool hospitalization, multiple admissions and later educational attainment and behaviour. Child Care Health Dev 1988; 14:275-291.
Henderson J, Goldacre MJ, Fairweather JM, Marcovitch H. Conditions accounting for substantial time spent in hospitalin children aged 1–14 years. Arch Dis Child 1992; 67: 83-86.
Kozak, LJ, Norton C, McManus M, McCarthy E. Hospitaluse patterns for children in the United States, 1983 and 1984. Pediatrics 1987; 80:418-490.
Perrin JM, Homer CJ, Berwick DM, Woolf AD, Freeman JL, Wennberg JE. Variations in rates of hospitalization of children in three urban communities. N Engl J Med 1989; 320:1183-1187.
McCaig LF. National Hospital Ambulatory Medical Care Survey: 1995 Outpatient Department Summary. Hyattsville, MD: National Center for Health Statistics, 1997.
Chabra, A, Chavez GF, Taylor D. Hospital use by pediatric patients: implications for change. Am J Prev Med 1997; 13(suppl2);30-37.
Health, United States, 1996–97 and Injury Chartbook. Hyattsville, MD: National Center for Health Statistics, 1997.
Newacheck PW, Hughes DC, Stoddard JJ. Children's access to primary care: differences by race, income, and insurance status. Pediatrics 1996; 97:26-32.
Newacheck PW, Taylor WR. Childhood chronic illness: Prevalence, severity, and impact. Am J Public Health 1992; 82:364-371.
Weissman JS, Gatsonis C, Epstein AM. Rates of avoidable hospitalization by insurance status in Massachusetts and Maryland. JAMA 1992; 268:2388-2394.
Costello EJ, Costello AJ, Edelbrock C, et al. Psychiatric disorders in pediatric primary care: Prevalence and risk factors. Arch Gen Psychiatry 1988; 45:1107-1116.
Starfield B, Katz H, Gabriel A, et al. Morbidity in childhood: a longitudinal view. New Engl J Med 1984; 310:824-829.
Sarles RM, Alessi N. Resolved: Two-week psychiatric hospitalizations of children and adolescents are useless. J Am Acad Child Adolesc Psychiatry 1993; 32:215-220.
Pfeiffer SI, Strzelecki SC. Inpatient psychiatric treatment of children and adolescents: a review of outcome studies. J Am Acad Child Adolesc Psychiatry 1990; 29:847-853.
Meux EF, Stith SA, Zach A. Report of Results From the OSHPD Reabstracting Project: An Evaluation of the Reliability of Selected Patient Discharge Data July Through December 1988. Sacramento, CA: Office of Statewide Health Planning and Development, State of California; 1990.
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Chabra, A., Chávez, G.F. A Comparison of Long Pediatric Hospitalizations in 1985 and 1994. Journal of Community Health 25, 199–210 (2000). https://doi.org/10.1023/A:1005104131310
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DOI: https://doi.org/10.1023/A:1005104131310