Trends in Resource Utilization by Children with Neurological Impairment in the United States Inpatient Health Care System: A Repeat Cross-Sectional Study
Open Access
- 17 January 2012
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLoS Medicine
- Vol. 9 (1), e1001158
- https://doi.org/10.1371/journal.pmed.1001158
Abstract
Care advances in the United States (US) have led to improved survival of children with neurological impairment (NI). Children with NI may account for an increasing proportion of hospital resources. However, this assumption has not been tested at a national level. We conducted a study of 25,747,016 US hospitalizations of children recorded in the Kids' Inpatient Database (years 1997, 2000, 2003, and 2006). Children with NI were identified with International Classification of Diseases, 9th Revision, Clinical Modification diagnoses resulting in functional and/or intellectual impairment. We assessed trends in inpatient resource utilization for children with NI with a Mantel-Haenszel chi-square test using all 4 y of data combined. Across the 4 y combined, children with NI accounted for 5.2% (1,338,590) of all hospitalizations. Epilepsy (52.2% [n = 538,978]) and cerebral palsy (15.9% [n = 164,665]) were the most prevalent NI diagnoses. The proportion of hospitalizations attributable to children with NI did not change significantly (p = 0.32) over time. In 2006, children with NI accounted for 5.3% (n = 345,621) of all hospitalizations, 13.9% (n = 3.4 million) of bed days, and 21.6% (US$17.7 billion) of all hospital charges within all hospitals. Over time, the proportion of hospitalizations attributable to children with NI decreased within non-children's hospitals (3.0% [n = 146,324] in 1997 to 2.5% [n = 113,097] in 2006, p<.001) and increased within children's hospitals (11.7% [n = 179,324] in 1997 to 13.5% [n = 209,708] in 2006, pPlease see later in the article for the Editors' SummaryKeywords
This publication has 38 references indexed in Scilit:
- Characteristics of Hospitalizations for Patients Who Use a Structured Clinical Care Program for Children with Medical ComplexityThe Journal of Pediatrics, 2011
- Hospital Utilization and Characteristics of Patients Experiencing Recurrent Readmissions Within Children's HospitalsJAMA, 2011
- Children With Complex Chronic Conditions in Inpatient Hospital Settings in the United StatesPEDIATRICS, 2010
- How Well Can Hospital Readmission Be Predicted in a Cohort of Hospitalized Children? A Retrospective, Multicenter StudyPEDIATRICS, 2009
- Thrombolysis for Ischemic Stroke in ChildrenStroke, 2007
- A national perspective of surgery in children with cerebral palsyPediatric Rehabilitation, 2006
- Costs and complications of hospitalizations for children with cerebral palsyPediatric Rehabilitation, 2006
- Children with chronic conditions in a paediatric emergency departmentActa Paediatrica, 2006
- Comparing the supply of pediatric subspecialists and child neurologistsThe Journal of Pediatrics, 2005
- Cerebral palsy: What do medical students know and believe?Journal of Paediatrics and Child Health, 2005