Emergency Department Visits Among California Children, 2016-2020
California children ages 0 to 17 made almost 1.2 million fewer visits to emergency departments in 2020 than in 2019—a drop of 43%, according to the latest data. Similarly, the state’s 171,769 child hospitalizations in 2020 represented a 22% decline from the previous year.
These drops are likely due to a combination of pandemic-related reasons and behavioral changes. Social distancing and decreased physical activity may have lowered the incidence of certain illnesses and injuries. At the same time, hospital avoidance may have resulted in unmet care needs for some children.
The mix of reasons for emergency department visits and hospitalizations also tell an important story—the shares for asthma/bronchitis fell, while the shares for traumatic injury rose. In addition, trends show that emergency department visits involving child maltreatment did not fall as fast as emergency visits overall.
The latest data also reveal that the top reasons for children’s hospital visits have stayed the same for years:
Injuries, Viruses Spur Many Emergency Department Visits
- Traumatic injuries and viral fevers or illnesses are consistently the most common primary diagnoses among pediatric emergency department (ED) visits statewide, representing about 12% and 8%, respectively, of all visits in 2020.
- The share of ED visits due to these top causes varies by county. For example, since 2016 Marin County has had the highest percentage of visits due to traumatic injuries (20% in 2020)—more than double Imperial County’s rate (9% in 2020).
Mental Illness Main Reason for Hospitalization
- Since 2008, mental illness has been the most common reason for childhood hospitalization in California (17% of hospitalizations in 2020).
- The next most common diagnosis is asthma/bronchitis (5% of hospitalizations in 2020).
- Similar to ED visits, the share of hospitalizations for these reasons varies widely at the local level. For instance, in 2020, the percentage of hospital discharges for mental diseases and disorders was higher than 25% for Placer and Sonoma counties and lower than 10% for Butte, Imperial, and Santa Barbara counties.
Medi-Cal Program Pays for Most Hospital Visits
- Medi-Cal is the payment source for most childhood ED visits, covering 63% of visits statewide in 2020. At the county level, the portion of ED visits covered by Medi-Cal ranged from 33% to 80%. Private insurance covered 29% of ED visits statewide in 2020, similar to previous years.
- For childhood hospitalizations, Medi-Cal paid for just over half (51%) in 2020, whereas private insurance covered 37%. Since 2002, Medi-Cal has covered a growing share of hospitalizations, while the share covered by private insurers has shrunk.
New Dataset: Hospital Visits Due to Child Maltreatment
KidsData has added a new set of indicators on ED visits and hospitalizations due to suspected or confirmed child abuse or neglect. Among the key findings:
- In 2020, California children had 2,826 visits to EDs and 873 hospitalizations for maltreatment-related injuries, both down from 2019.
- Since 2016, the two most common types of abuse and neglect treated in EDs have been sexual abuse or exploitation (60% in 2020) and physical abuse (24%), while hospitalizations have most often involved physical abuse (54% in 2020) and neglect or abandonment (26%).
- California infants under age 1 are much more likely to be hospitalized for maltreatment than older children—in 2020, the rate of infant ED visits for maltreatment was 81 per 100,000—no other age group has a rate above 14 per 100,000. Infants also were most likely to visit the ED for abuse or neglect in 2020 (46 visits per 100,000), followed by children ages 3 to 5 (45 visits per 100,000). For all age groups but infants, ED visit rates fell from 2019 to 2020.
- In 2020, the statewide rate of ED visits for abuse or neglect among African American/Black children (23 visits per 100,000) was almost three times that of Hispanic/Latino children, four times that of white children, and eight times that of multiracial children. Across years, African American/Black children consistently are the group most likely to be hospitalized for maltreatment.
- Medi-Cal covered around two thirds of ED visits (67%) and hospitalizations (64%) for child abuse or neglect in 2020, whereas private insurance covered around 1 in 5 (19% each).
Funding for KidsData.org’s new information on child maltreatment-related ED visits and hospitalizations is provided by the California Department of Public Health, Injury and Violence Prevention Branch, Essentials for Childhood Initiative.
Join us for “Child Maltreatment-Related Injuries During the COVID-19 Pandemic in California,” a webinar hosted by the California Essentials for Childhood Initiative and KidsData, on Thursday, September 29, from 10:00 a.m. to 11:00 a.m. PT.
The White House Office of Science and Technology Policy is asking for public input on how the federal government can better produce data on sexual orientation and gender identity to address disparities; promote equity; and protect privacy, security, and civil rights. Submit your comments by October 3.
The National Institutes of Health is offering up to $8 million in cash prizes to accelerate development of home-based or point-of-care technologies to improve postpartum outcomes. Submissions for the first phase of awards are due November 1.
Child poverty, calculated by the Supplemental Poverty Measure (SPM), fell to its lowest recorded level in 2021, declining 46% from 9.7% in 2020 to 5.2% in 2021, according to U.S. Census Bureau data released this month.
The Hearing Aid Coverage for Children Program may soon extend eligibility to families with partial insurance coverage and to youth up age 21, helping an additional 2,000 young people.
KidsData in the News
A Noozhawk story cited KidsData on the share of public school students who experience homelessness.
Recently Released Data
We recently released data about child abuse and neglect and hospital use. See links to the latest here.
Posted by kidsdata.org