Hospital Discharges, by Source of Payment
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Learn More About Hospitalizations

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.
Hospitalizations
Asthma
Demographics of Children with Special Needs
Access to Services for Children with Special Health Care Needs (State-Level Data)
Cancer
Insurance Coverage for Children with Special Health Care Needs (State-Level Data)
Impact of Special Health Care Needs on Children & Families (State-Level Data)
Deaths
Emotional/Mental Health
Quality of Care for Children with Special Health Care Needs (State-Level Data)
Health Care
Infant Mortality
Suicide and Self-Inflicted Injury
Injuries
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:

  1. 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
  2. Guidelines for Pediatric Cancer Centers: AAP Policy Statement. (2004). American Academy of Pediatrics, 113(6); 1833-1835.
  3. 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
  4. 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
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
Key Reports
County/Regional Reports
More Data Sources For Hospitalizations