Hospital discharge data include all hospital visits in which the child was admitted for care, but do not include emergency room visits or the births of newborns. A hospital admission occurs when the child's condition is serious enough that the patient requires extended care (i.e., an overnight stay that includes tests, monitoring, and further observation). On kidsdata.org, information on hospital discharges -- patients who leave the hospital after a period of care -- includes data on sources of payment for services, and the most common primary diagnoses for hospital stays. These data represent the child's county of residence, rather than the location of the hospital.
It is essential that all children have access to high-quality, accessible, and affordable health care, including hospital stays, when needed. Children with special health care needs, in particular, may require more frequent hospitalizations and specialized, intensive medical care. Ensuring that all children have consistent access to affordable care that is also evidence-based, well-coordinated, family-centered, and provided in the context of a “medical home” can maximize positive outcomes (1, 2).
The hospitalization data on kidsdata.org are based on hospital
discharges. Typically, hospital discharge data provide information about
patients who are hospitalized (e.g., age, race, gender, and residence),
the conditions for which they are hospitalized, the treatments they
received, and costs of their care (3). These data can be useful to
illuminate trends in public safety and health and can inform injury
prevention or disease surveillance (3). For example, asthma is one of
the most common diagnoses for hospital stays among children, statewide
and nationally (4). Research examining hospital discharge data has found
that asthmatic children in neighborhoods with high levels of
overcrowding and poverty are more likely to be re-admitted for hospital
care than those living in less-disadvantaged areas. Asthmatic children
covered by Medicaid instead of private insurance also are more likely to
be re-admitted for care (4). Hospital discharge data, which is
relatively inexpensive to collect compared to other kinds of health care
data, can be a highly useful means of informing health care policy (3).
For more information on hospitalizations, see kidsdata’org’s Research & Links section.
Sources for this narrative:
- Health Resources and Services Administration. (2006). Six Core Outcomes. The National Survey of Children with Special Health Care Needs Chartbook, 2005-2006. Retrieved from: http://mchb.hrsa.gov/cshcn05/MI/cokmp.pdf
- Guidelines for Pediatric Cancer Centers: AAP Policy Statement. (2004). American Academy of Pediatrics, 113(6); 1833-1835.
- Shoenman, J.A., et al. (2005). The value of hospital discharge databases. Bethesda: NORC at the University of Chicago in cooperation with the National Association of Health Data Organizations. Retrieved from: http://hcup-us.ahrq.gov/reports.jsp
- Liu, S. Y., & Pearlman, D. N. (2009). Hospital readmission for childhood asthma: The role of individual and neighborhood factors. Public Health Reports, 124(1), 65-78. Retrieved from: http://www.publichealthreports.org/issuecontents.cfm?Volume=124&Issue=1
Asthma/bronchitis and mental illness are the leading two diagnoses for children who are hospitalized in California. Asthma can lead to hospitalization when it is severe and not well-controlled. Children of color and low-income children have much higher hospitalization, prevalence, and morbidity rates for asthma than white and higher-income children. (1)
According to research and subject experts, policies that could address the leading causes of hospitalization among children—asthma and mental illness — include:
- Ensuring that all children have high-quality, accessible, and affordable health care to promote prevention and effective management of asthma and mental illness (1)
- Expanding and improving mental health services for youth, including by implementing government-funded programs for prevention and early intervention so that disorders can be diagnosed and treated early (2, 3)
- Ensuring that mental health insurance benefits are sufficient in amount and scope to be effective
For more policy ideas and research on this topic, visit kidsdata.org's Research & Links section on this page. Also see Policy Implications on kidsdata.org under Asthma and Health Care.
Sources for this narrative:
- California Department of Public Health. (2008). Strategic plan for asthma in California 2008-2012. Retrieved from: http://www.cdph.ca.gov/programs/caphi/Documents/AsthmaStrategicPlan.5-5-08.pdf
- California Adolescent Health Collaborative. Mental health in adolescence: A critical time for prevention and early intervention. Retrieved from: http://www.californiateenhealth.org/wp-content/uploads/2011/06/Mental_Health_Fact_Sheet.pdf
- Greenberg, M. T., et al. Preventing mental disorders in school-age children: A review of the effectiveness of prevention programs. Retrieved from: http://prevention.psu.edu/pubs/documents/mentaldisordersfullreport.pdf
In 2011, more than 257,000 children were discharged from hospitals in California, a decrease of about 12% since 2002. Asthma/bronchitis and mental diseases/disorders were the most common reasons for hospital stays during 2002-2011. Medi-Cal covered expenses for about half (50.3%) of children discharged from hospitals in 2011, an increase from 45.9% in 2002; private insurance covered expenses for 39.4% in 2011, a decline from 46.1% in 2002.