Trends in pediatric hospitalizations of children in washington state by insurance and chronic condition status, 1991-1998.
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.
Neff
John M
JM
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
Valentine
Jeanette
J
Park
Alice
A
Hicks-Thomson
Jan
J
Christakis
Dimitri A
DA
Muldoon
John
J
Churchill
Shervin
S
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