Overview of Hospital Stays for Children in the United States, 2012 #187

Overview of Hospital Stays for Children in the United States, 2012 #187

Overview of Hospital Stays for Children in the United States, 2012

Whitney P. Witt, Ph.D. M.P.H., Audrey J. Weiss, Ph.D., and Anne Elixhauser, Ph.D.







Introduction



Nearly one out of every six discharges from U.S. hospitals in 2012 was for children aged 17 years and younger, the majority of whom were infants, including newborns.¹ Between 2008 and 2012, the rate of hospitalization decreased by 0.6 percent per year among infants and 0.9 percent per year among children aged 1-17 years.² During this same time period, average annual growth in mean hospital costs per stay was 6.7 percent for infants and 6.4 percent for children aged 1-17 years, more than three times the rate of cost growth of any other age group.³



A variety of factors may explain the recent trends in children's hospitalizations, including changes in the conditions for which children are being treated. One recent study of children's inpatient stays in pediatric hospitals found that the number of patients, aggregate hospital charges, and number of hospital days grew more rapidly between 2004 and 2009 among children with chronic conditions than among those without chronic conditions.⁴ Children with multiple chronic conditions also were more likely to be covered by Medicaid than were those without a chronic condition.⁵ Understanding the reasons why children are hospitalized and examining trends over time is critical to inform clinical practice and health policy.



This Healthcare Cost and Utilization Project (HCUP) Statistical Brief presents data on hospital inpatient stays among children aged 17 years and younger in 2012. Data were taken from the HCUP Kids' Inpatient Database (KID), which is created once every 3 years. The KID is the only database specifically developed to study hospitalizations among children. This Statistical Brief updates previously published information^6,7 using the KID and examines trends over time.



In this Statistical Brief, we present characteristics of hospital stays among children aged 0-17 years, in comparison to hospital stays among adults aged 18-44 years. The distribution of hospital stays and aggregate hospital costs by pediatric age group is provided. Trends in the distribution of stays among children by primary payer from 2000 to 2012 also are shown. Finally, the most common types of conditions and operating room (OR) procedures for hospital stays among children are presented. All differences between mean estimates noted in the text are statistically significant at the .001 level or better. Differences between proportions noted in the text differ by at least 10 percent.



Findings



Characteristics of hospital stays among children, 2012

Table 1 presents characteristics of inpatient hospitalizations among children (aged 0-17 years) compared with adults (aged 18-44 years)

Highlights

In 2012 there were nearly 5.9 million hospital stays for children in the United States, of which 3.9 million were neonatal stays and 104,700 were maternal stays for pregnant teens. Between 2000 and 2012, the number of neonatal stays (births) fluctuated around 4.0 million stays, reaching a high of 4.3 million in 2006. Hospital stays for teen pregnancies decreased by 47 percent over the 12-year period. In 2012, Medicaid covered over half (51.6 percent) of nonneonatal and nonmaternal stays for children and about a quarter (26.4 percent) of stays for adults aged 18-44 years. In contrast, 2.7 percent of stays for children were uninsured compared with 16.9 percent of stays for adults aged 18-44 years. From 2000 to 2012, the proportion of hospital stays for children paid by Medicaid increased by 33 percent, and the proportion paid by private insurance decreased by 21 percent. For most conditions, the rate of hospitalization for children decreased or remained relatively unchanged from 2000 to 2012. Only skin conditions showed an increase in rate of hospitalization (35.6 percent). Substantial decreases in rates of hospitalization over the 12-year period were observed for HIV infection (89.9 percent) and substance abuse (60.1 percent). Respiratory diagnoses—pneumonia, acute bronchitis, and asthma; mood disorders; appendicitis; and epilepsy/ convulsions were the most common specific conditions for which children were hospitalized.