title: Trends in pediatric hospitalizations of children in washington state by insurance and chronic condition status, 1991-1998.
abstract: OBJECTIVE
  To examine the possible impact of changes in the organization and management of the Medicaid program on hospitalization patterns for children with chronic and nonchronic conditions between January 1, 1991, and December 31, 1998.
  
  
  METHODS
  Longitudinal retrospective study of hospitalization patterns of children in 4 strata: Medicaid, non-Medicaid, chronic conditions, and nonchronic conditions.
  
  
  METHODS
  Washington State.
  
  
  METHODS
  Hospital discharge abstract records for all children aged 0 to 17 years profiled into those with and without a chronic condition, Medicaid, and non-Medicaid using a diagnosis-based classification system.
  
  
  METHODS
  Hospitalization and multiple hospitalization rates and length of hospital stay.
  
  
  RESULTS
  In 1991, hospitalization and multiple hospitalization rates were higher for all Medicaid vs non-Medicaid children. From 1991 to 1998, there was a decrease in the hospitalization and multiple hospitalization rates for Medicaid children only. By 1998, rates for Medicaid children approximated those for non-Medicaid children. This decrease was greater for nonchronically ill children than for chronically ill children. Total hospitalizations in Medicaid children decreased by 4.5%. The mean length of stay in 1991 for all Medicaid hospitalized children was higher than that for non-Medicaid children (6.1 vs 5.1 days). By 1998, the length of stay decreased for both groups (5.7 vs 4.9 days).
  
  
  CONCLUSIONS
  The declines in hospitalization and multiple hospitalization rates observed in Washington State Medicaid children from 1991 to 1998 may be the result of many statewide efforts to increase access and improve management for this population.
authors.affiliation: Center for Children With Special Needs, Children's Hospital and Regional Medical Center, 4800 Sand Point Way NE, CM-09, Seattle, WA 98105-0371, USA. jneff@chmc.org
authors.forename: John M
authors.initials: JM
authors.lastname: Neff
authors.forename: Jeanette
authors.initials: J
authors.lastname: Valentine
authors.forename: Alice
authors.initials: A
authors.lastname: Park
authors.forename: Jan
authors.initials: J
authors.lastname: Hicks-Thomson
authors.forename: Dimitri A
authors.initials: DA
authors.lastname: Christakis
authors.forename: John
authors.initials: J
authors.lastname: Muldoon
authors.forename: Shervin
authors.initials: S
authors.lastname: Churchill
mesh_terms: D000293:Adolescent; D002648:Child; D002673:Child, Hospitalized / Q000706:statistics & numerical data*; D002675:Child, Preschool; D002908:Chronic Disease / Q000453:epidemiology; D005260:Female; D017722:Hospital Charges; D006760:Hospitalization / Q000706:statistics & numerical data* / Q000639:trends*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D008137:Longitudinal Studies; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000706:statistics & numerical data; D011203:Poverty; D012189:Retrospective Studies; D014861:Washington / Q000453:epidemiology