Recent trends in pediatric hospitalization in New York state.

Abstract

To describe changing rates of disorders associated with child hospitalization. Trends for the 100 diagnosis related groups (DRGs) with the largest number of hospitalizations (0-14 years) were analyzed. Children were hospitalized at an average annual rate of 35 per 1000 age-specific population during 1996 to 2002. The hospitalization rate decreased by 2.3% per year. The top 100 DRGs accounted for 90% of all 949,376 child hospitalizations. Hospitalization for mental illness increased by 5.5% per year, accounting for more than 4% of all child hospitalizations in 2002. Ambulatory care-sensitive medical conditions (asthma, gastrointestinal disorders, pneumonia, seizures) continue to be leading causes of hospitalization, and they are declining no faster than the overall rate. DRGs with a significantly faster rate of decline than the overall trend included surgical procedures for which inpatient care is often unnecessary (-12.3%/year, accounting for 11% of the overall decline) trauma-related diagnoses (-4.4%/year, accounting for 7% of the overall decline), and HIV-related conditions (-31.7%/year, accounting for 3% of the overall decline). The rising rate of hospitalization associated with child mental illness may represent a clinically important trend. Rates of hospitalization for ambulatory care-sensitive conditions have not declined substantially despite the availability of evidence-based strategies to avoid serious illness.