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- Definition: Number of children ages 0-17, excluding newborns, discharged from hospitals, by place of residence and source of payment.Percentage of children ages 0-17, excluding newborns, discharged from hospitals, by place of residence and source of payment (e.g., Medi-Cal covered expenses for 50.5% of children discharged from hospitals in California in 2012).
- Data Source: Special Tabulation by the State of California, Office of Statewide Health Planning and Development (Nov. 2013).
- Footnote: For detailed definitions of each source of payment, see the Glossary of Healthcare Terms Used by OSHPD Data Programs. LNE (Low Number Event) refers to data that have been suppressed because there were fewer than 5 cases. Data are excluded for a relatively small number of cases for which county identification is unknown, for patients with erroneous birth dates, and where source of payment is unknown, not reported, or reported in error.
- Demographics of Children with Special Needs
- Active California Children's Services (CCS) Enrollees, by Age and County
- Children with Special Health Care Needs (California & U.S. Only)
- Children with Four or More Functional Difficulties, by Type of Insurance (California & U.S. Only)
- Overweight or Obese Children, by Special Needs Status (California & U.S. Only)
- Percentage of Insured/Uninsured Children Who Have Special Health Care Needs (California & U.S. Only)
- Poverty Among Children with Special Health Care Needs, by Race/Ethnicity (California & U.S. Only)
- Children with Major Disabilities (Regions of 65,000 Residents or More)
- Children with Major Disabilities (Regions of 20,000 Residents or More)
- Access to Services for Children with Special Health Care Needs (State-Level Data)
- Insurance Coverage for Children with Special Health Care Needs (State-Level Data)
- Impact of Special Health Care Needs on Children & Families (State-Level Data)
- Emotional or Behavioral Difficulties Among Children with Special Health Care Needs
- Children with Special Health Care Needs Whose Conditions Consistently and/or Greatly Affect Their Daily Activities
- Children with Special Needs Whose Families Spend 11 Hours or More a Week on the Child’s Health Care
- Impact of Child's Special Health Care Needs on Parental Employment
- Out-of-Pocket Expenses for Children with Special Health Care Needs, by Adequacy of Insurance
- Overnight Hospital Stays Among Children with Special Health Care Needs
- Children with Special Health Care Needs Whose Conditions Caused Family Financial Problems
- Emotional/Mental Health
- Quality of Care for Children with Special Health Care Needs (State-Level Data)
- Health Care
- Delayed or No Medical Care
- Health Insurance Coverage (Regions of 65,000 Residents or More), by Type of Insurance and Age
- Health Insurance Coverage (Regions of 20,000 Residents or More), by Type of Insurance and Age
- Medi-Cal Enrollment
- Length of Time Since Last Routine Health Check-Up
- Medical Home Access (California & U.S. Only)
- Uninsured at Any Point in Last Year
- Visited the Emergency Room in Last Year, by Type of Insurance
- Infant Mortality
- Suicide and Self-Inflicted Injury
- Why This Topic Is Important
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. (2011). Children with Special Health Care Needs in context: A portrait of states and the nation 2007. Medical home. Retrieved from: http://mchb.hrsa.gov/nsch/07cshcn/national/1chhc/2iaqc/pages/07mh.html
- 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
- Measures of Hospitalizations on Kidsdata.org
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.
- How Children Are Faring
In 2012, more than 247,000 children under age 18 were hospitalized in California, a decrease of about 15% since 2002. Mental diseases/disorders and asthma/bronchitis were the most common reasons for hospitalization among children discharged between 2002 and 2012. Medi-Cal covered expenses for about half (50.5%) of children hospitalized in 2012, and private insurance covered expenses for more than a third (38.6%). Since 2002, the percentage of children whose costs were covered by private insurers has decreased, while the percentage of children whose costs were covered by Medi-Cal has increased.
- Policy Implications
Asthma/bronchitis and mental illness are the two leading 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 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)
- Promoting community-wide, integrated interventions to decrease the burden of asthma on high-risk populations, including: strategies to improve health insurance coverage of the uninsured and underinsured, education and outreach, home visiting, and the reduction of asthma triggers in schools, child care centers, homes, and workplaces (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)
- Ensuring that mental health insurance benefits are sufficient in amount and scope to be effective (3)
- Providing routine and accessible mental health screening and services to youth to address depression and prevent youth self-harm (3)
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, Health Care, and Emotional Health.
Sources for this narrative:
1. 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
2. California Adolescent Health Collaborative. (2011). 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
3. Report of the U.S. Surgeon General and of the National Action Alliance for Suicide Prevention. (2012). National strategy for suicide prevention 2012: Goals and objectives for action. Retrieved from: http://store.samhsa.gov/product/National-Strategy-for-Suicide-Prevention-2012-Goals-and-Objectives-for-Action/PEP12-NSSPGOALS
- Websites with Related Information
- Asthma in Children and Adolescents Knowledge Path, Maternal and Child Health Library at Georgetown University
- Child and Adolescent Health, Agency for Healthcare Research and Quality
- Child Health USA, U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau
- Children and Adolescents with Special Health Care Needs Knowledge Path
- Emotional, Behavioral and Mental Health Challenges in Children and Adolescents Knowledge Path
- Healthcare Cost & Utilization Project (H-CUP), Agency for Healthcare Research and Quality
- National Association of Children’s Hospitals
- National Institute of Mental Health: Child and Adolescent Mental Health
- Safe Kids Worldwide
- Key Reports
- Annual Report on Health Care for Children and Youth in the United States: Focus on Trends in Hospital Use and Quality, Academic Pediatrics
- Child Health Research: Identifying Quality Problems and Improving Care, Agency for Healthcare Research and Quality
- Hospital Stays for Children, 2009, Healthcare Cost and Utilization Project
- Improvements in Access to Care for Vulnerable Children in California Between 2001 and 2005, Public Health Reports
- Inpatient Growth and Resource Use in 28 Children's Hospitals: A Longitudinal, Multi-institutional Study, JAMA Pediatrics
- Overview of Childhood Injury Morbidity and Mortality in the U.S., Safe Kids Worldwide
- Preventable Hospitalizations in California, Office of Statewide Health Planning and Development
- Racial and Ethnic Disparities in the Health and Health Care of Children, Pediatrics
- Securing a Healthy Future: The Commonwealth Fund State Scorecard on Child Health System Performance, The Commonwealth Fund
- The Lifelong Effects of Early Childhood Adversity and Toxic Stress, American Academy of Pediatrics
- County/Regional Reports
- Changing the Odds for Our Children: Santa Clara County Children's Agenda, Kids in Common
- Expanding Coverage for Children: Santa Clara County's Children's Health Initiative, Mathematica Policy Research Inc.
- Final Report of the Evaluation of the San Mateo County Children's Health Initiative, Urban Institute
- Frequent Users of Health Services Initiative: Final Evaluation Report, The California Endowment and California Health Care Foundation
- Kern County Report Card, Kern County Network for Children
- Santa Barbara County Children's Scorecard, Santa Barbara County KIDS Network
- Tulare County Children’s Report Card 2010, Children's Services Network