Topic Summary

Summary: Hospitalizations

All Indicators In This Topic
Hospital Discharges
Spotlight on Key Indicators: Hospitalizations
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Learn More About Hospitalizations

Hospitalizations
Asthma
Characteristics of Children with Special Needs
Access to Services for Children with Special Needs
Children's Emotional Health
Insurance Coverage for Children with Special Health Care Needs
Impact of Special Health Care Needs on Children & Families
Health Care
Youth Suicide and Self-Inflicted Injury
Injuries
Why This Topic Is Important
All children should 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, evidence-based, well-coordinated, and family-centered care—all within the context of a medical home—can maximize positive outcomes (1, 2).

Hospitalization indicators on kidsdata.org are based on hospital discharges. These data can be useful to illuminate public safety and health trends and can inform injury prevention and 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 living 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 childhood hospitalizations, see kidsdata.org’s Research & Links section.

Sources for this narrative:

1.  Health Resources and Services Administration, Maternal and Child Health Bureau. (2014). Medical home. In The health and well-being of children: A portrait of states and the nation, 2011-2012. U.S. Department of Health and Human Services. 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 & 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

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: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2602932
How Children Are Faring
In 2017 there were 227,432 hospital discharges among California children ages 0-17, 22% fewer than fifteen years earlier. Nearly one in seven (14%) of these hospital stays were for a primary diagnosis of mental disease or disorder, followed by asthma/bronchitis (8%), pneumonia/pleurisy (4%), and seizures/headaches (4%). Although mental diseases and disorders have been the most common cause of childhood hospitalization statewide since 2008, there is wide variation across regions. For example, in 2017, the percentage of discharges for mental diseases and disorders among children in San Mateo County was more than 11 times greater than the percentage for children in Imperial County.

Among California children discharged in 2017, Medi-Cal covered the hospitalization expenses for more than half (55%) of these visits, compared with about one-third (35%) for private insurance. Since 2002, the percentage of visits with costs covered by private insurers has decreased, while the percentage with costs covered by Medi-Cal has increased.
Policy Implications
Hospital admissions and re-admissions can be reduced through effective care coordination and discharge planning, especially for children with special health care needs. Furthermore, detailed hospital discharge data can reveal the conditions and populations for which targeted care management and preventive services could have the greatest impact.

Policy options that could reduce hospital stays among children in general, and for the leading causes of hospitalization statewide—asthma and mental illness—include:
  • Reducing care fragmentation and inefficiency within and across health systems by establishing care coordination services that are patient- and family-centered, assessment-driven, team-based, and designed to meet the needs of children and youth while enhancing the caregiving capabilities of families (1)
  • Implementing a standardized, pediatric-specific framework for the transition from hospital to home care that begins at the time of admission, involves the entire care team, engages the child's family, acknowledges the family's circumstances at home, provides clear and comprehensive documentation, and follows up with the family after discharge (2)
  • Ensuring that all children have high-quality, accessible, and affordable health care to promote prevention and effective management of asthma, mental illness, and other special health care needs (3, 4)
  • Promoting community-wide, integrated interventions to decrease the burden of asthma on high-risk populations, such as low-income families and children of color, including strategies to improve health insurance coverage among the uninsured and under-insured, home visiting, education and outreach, and the reduction of asthma triggers in schools, child care centers, homes, and workplaces (3)
  • Adopting a comprehensive, evidence-based approach to mental health services for youth that expands and improves prevention, diagnosis, and early intervention services, while also promoting mental thriving and providing access to wellness supports for all children and families (4)
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 Children's Emotional Health.

Sources for this narrative:

1.  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

2.  Berry, J. G., et al. (2014). A framework of pediatric hospital discharge care informed by legislation, research, and practice. JAMA Pediatrics, 168(10), 955-962. Retrieved from: http://jamanetwork.com/journals/jamapediatrics/article-abstract/1899237

3.  California Department of Public Health. (2015). Strategic plan for asthma in California: 2015-2019. Retrieved from: https://www.cdph.ca.gov/Programs/CCDPHP/DEODC/EHIB/CPE/CDPH Document Library/SPAC2014_7-28-15APR.pdf

4.  Murphey, D., et al. (2014). Are the children well? A model and recommendations for promoting the mental wellness of the nation’s young people. Child Trends & Robert Wood Johnson Foundation. Retrieved from: http://www.rwjf.org/en/library/research/2014/07/are-the-children-well-.html
Websites with Related Information
Key Reports and Research
County/Regional Reports
More Data Sources For Hospitalizations