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- Definition: Number of children ages 0-17, excluding newborns, discharged from hospitals, by source of payment.Percentage of children ages 0-17, excluding newborns, discharged from hospitals, by source of payment (e.g., Medi-Cal covered expenses for 54.3% of children discharged from hospitals in California in 2014).
- Data Source: Special tabulation by the State of California, Office of Statewide Health Planning and Development (Sept. 2015).
- Footnote: County-level data reflect the patient's county of residence, not the county in which the hospitalization occurred. 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 or because the number of cases in a category represents less than 0.1% of the total. Data are excluded for a relatively small number of cases for patients with erroneous birth dates, and where source of payment is unknown, not reported, or reported in error. Data are also excluded from county totals, but included in state totals, for a relatively small number of cases in which county identification is unknown.
- 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.
- Characteristics of Children with Special Needs
- Active California Children's Services (CCS) Enrollees, by Age Group
- 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)
- Children with Major Disabilities, by City, School District and County (Regions of 65,000 Residents or More)
- Children Who Are Overweight or Obese, by Special Needs Status (California & U.S. Only)
- Insured/Uninsured Children Who Have Major Disabilities, by City, School District and County (Regions of 65,000 Residents or More)
- Insured/Uninsured Children Who Have Special Health Care Needs, by Type of Insurance (California & U.S. Only)
- Poverty Among Children with Special Health Care Needs, by Race/Ethnicity (California & U.S. Only)
- Emotional or Behavioral Difficulties Among Children with Special Health Care Needs (California & U.S. Only)
- Access to Services for Children with Special Health Care Needs
- Children's Emotional Health
- Insurance Coverage for Children with Special Health Care Needs
- Insurance Coverage for Children with Special Health Care Needs, by Insurance Status (California & Other States Only)
- Consistency of Insurance Coverage, by Special Needs Status (California & U.S. Only)
- Adequacy of Insurance Coverage Among Insured Children, by Special Needs Status (California & U.S. Only)
- Impact of Special Health Care Needs on Children & Families
- Children with Special Health Care Needs Whose Conditions Caused Family Financial Problems (California & Other States Only)
- Children with Special Health Care Needs Whose Conditions Consistently and/or Greatly Affect Their Daily Activities (California & U.S. Only)
- Children with Special Health Care Needs Whose Families Spend 11 Hours or More a Week on the Child’s Health Care (California & U.S. Only)
- Impact of Child's Special Health Care Needs on Parental Employment (California & U.S. Only)
- Out-of-Pocket Expenses for Children with Special Health Care Needs, by Adequacy of Insurance (California & U.S. Only)
- Overnight Hospital Stays Among Children with Special Health Care Needs (California Only)
- Quality of Care for Children with Special Health Care Needs
- Receipt of Family-Centered Health Care for Children with Special Health Care Needs (California & U.S. Only)
- Receipt of Care Within a Medical Home for Children with Special Health Care Needs (California & U.S. Only)
- Health Care
- Delayed or No Medical Care
- Length of Time Since Last Routine Health Check-Up
- Visited the Emergency Room in Last Year, by Type of Insurance
- Uninsured at Any Point in Last Year
- Health Insurance Coverage (Regions of 65,000 Residents or More), by Type of Insurance and Age
- Health Insurance Coverage (Regions of 10,000 Residents or More), by Type of Insurance and Age
- Medi-Cal Point-in-Time Enrollment
- Receipt of Care Within a Medical Home (Regions of 70,000 Residents or More)
- Adequate Health Services Provided at School (Staff Reported)
- Infant Mortality
- Youth Suicide and Self-Inflicted Injury
- Why This Topic Is Important
It is essential that all children have 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).For more information on hospitalizations, see kidsdata.org’s Research & Links section.
Sources for this narrative:
1. U.S. Department of Health and Human Services, Health Resources and Services Administration. (2014). The health and well-being of children: A portrait of states and the nation, 2011-2012. Retrieved from: http://mchb.hrsa.gov/nsch/2011-12/health/child/childs-health-care/medical-home.html
2. American Academy of Pediatrics, Council on Children with Disabilities and Medical Home Implementation Project Advisory Committee. (2014). Patient- and family-centered care coordination: A framework for integrating care for children and youth across multiple systems. Pediatrics, 133(5), e1451-e1460. Retrieved from: http://pediatrics.aappublications.org/content/133/5/e1451
3. Peters, A., et al. (2014). The value of all-payer claims databases to states. North Carolina Medical Journal, 75(3), 211-213. Retrieved from: http://www.ncmedicaljournal.com/content/75/3/211.abstract
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 2014, nearly 235,000 children under age 18 were hospitalized in California, a decrease of about 20% since 2002. Mental diseases/disorders and asthma/bronchitis were the most common reasons for hospitalization among children discharged between 2002 and 2014. Medi-Cal covered expenses for about half (54.3%) of children hospitalized in 2014, and private insurance covered expenses for more than a third (35.3%). Medicare, self-pay, workers compensation, county or other programs for low-income children, other government programs, and other payers covered expenses for the remaining percentage of children hospitalized in 2014. 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:
For more policy ideas and research on this topic, visit kidsdata.org's Research & Links section. Also see Policy Implications under Asthma, Health Care, and Emotional Health.
- 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 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)
Sources for this narrative:
1. Arnesen, C., et al. (2015). Strategic plan for asthma in California 2015-2019. California Department of Public Health. Retrieved from: http://www.ehib.org/paper.jsp?paper_key=STRATEGIC_ASTHMA_2003
2. Goldstein, S. (2008). Mental health in adolescence: A critical time for prevention and early intervention. California Adolescent Health Collaborative. Retrieved from: http://www.phi.org/resources/?resource=mental-health-in-adolescence-a-critical-time-for-prevention-and-early-intervention
3. U.S. Department of Health and Human Services Office of the Surgeon General, & National Action Alliance for Suicide Prevention. (2012). 2012 National strategy for suicide prevention: Goals and objectives for action. Retrieved from: http://www.surgeongeneral.gov/library/reports/national-strategy-suicide-prevention
- Websites with Related Information
- Asthma Knowledge Path, National Center for Education in Maternal and Child Health
- Children and Youth with Special Health Care Needs Knowledge Path, National Center for Education in Maternal and Child Health
- Emotional, Behavioral, and Mental Health Challenges in Children and Adolescents Knowledge Path, National Center for Education in Maternal and Child Health
- National Institute of Mental Health: Child and Adolescent Mental Health
- Key Reports
- Annual Report on Health Care for Children and Youth in the United States: National Estimates of Cost, Utilization and Expenditures for Children With Mental Health Conditions, 2015, Academic Pediatrics, Torio, C. M., et al.
- Inpatient Growth and Resource Use in 28 Children's Hospitals: A Longitudinal, Multi-Institutional Study, 2013, JAMA Pediatrics, Berry, J. G., et al.
- Overview of Childhood Injury Morbidity and Mortality in the U.S. Fact Sheet, 2015, Safe Kids Worldwide
- Patient- and Family-Centered Care Coordination: A Framework for Integrating Care for Children and Youth Across Multiple Systems, 2014, Pediatrics, American Academy of Pediatrics, Council on Children with Disabilities & Medical Home Implementation Project Advisory Committee
- Preventable Hospitalizations in California 1999-2008, Office of Statewide Health Planning and Development
- Racial and Ethnic Disparities in the Health and Health Care of Children, 2013, Pediatrics, Flores, G., & American Academy of Pediatrics Committee on Pediatric Research
- County/Regional Reports
- 2017 Kern County Report Card, Kern County Network for Children
- San Diego County Report Card on Children and Families, 2015, The Children's Initiative & Live Well San Diego
- Santa Clara County Children's Agenda: 2017 Data Book, Planned Parenthood & Kids in Common
- Santa Clara County Public Health Department: Data and Statistics
- More Data Sources For Hospitalizations
- California Health and Human Services Open Data Portal, California Health & Human Services Agency
- Healthcare Cost and Utilization Project (HCUP), U.S. Dept. of Health and Human Services, Agency for Healthcare Research and Quality
- Maternal and Child Health Bureau: National Survey Publications and Chartbooks, U.S. Dept. of Health and Human Services
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