Kids’ Admission to Specialty Care Hospitals Strongly Influenced by Non-Medical Factors
A recent study from Stanford University points out a troubling trend: Factors other than medical need appear to be influencing whether California children with chronic conditions are treated in hospitals with special expertise in caring for children.
On the positive side, the study provides evidence that the majority of chronically ill children who require hospitalization are admitted to these specialty care centers. More disturbing is the fact that the data suggest that factors other than medical need play a major role in influencing where children are hospitalized. Low-income children with public insurance generally are cared for in a children’s specialty care hospital. Surprisingly, though, children who are privately insured are significantly less likely to be treated at these pediatric centers of excellence.
In addition, other non-medical factors such as age, ethnicity, income level and living close to a specialty care hospital also influence where a child is treated, the study reports.
These findings are worrisome because a range of studies suggest that outcomes improve when children with serious or rare conditions have access to physicians and hospitals with special expertise.
The Stanford study analyzed pediatric hospitalizations for children ages 0 to 18 years at the time of admission in California between 1999 and 2007, using data from the Office of Statewide Health Planning and Development (OSHPD).
The authors recommend greater scrutiny of clinical practices and child health policies that shape patterns of hospitalization of children with serious chronic disease. Through our work regarding children with special health care needs, our Foundation is advocating for a system in which all children are able to receive the highest-quality health care when and where they need it.
Posted by David Alexander, MD
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