Utilization of pediatric hospitals in New York State.
BACKGROUND
Little published information is available regarding the proportion of hospitals that offer pediatric services at specified levels, or the actual utilization of such services.


OBJECTIVE
To determine if an existing national accreditation process created for educational purposes identifies hospitals with a distinct utilization pattern, in a sample of pediatric inpatient activity from one state.


METHODS
Hospitals in New York State were classified as "pediatric" hospitals according to their sponsorship or major participation with an accredited pediatric residence program. Institutions not affiliated with pediatric residencies were considered to be the "other" hospitals. Data on hospital discharges and interhospital transfers were studied for children from 0 to 14 years old, excluding neonatal Diagnosis-Related Groups. Data were obtained from the New York Statewide Planning and Research Cooperative System for 1996, 1997, and 2000.


RESULTS
Sixteen percent of hospitals were considered to be "pediatric" facilities (42 of 257) by study criteria. Annual pediatric inpatient activity per "pediatric" hospital significantly exceeded that in "other" institutions, including hospitalizations (2249 +/- 1284 vs 258 +/- 348), number of interhospital transfers received (153 +/- 88 vs 18 +/- 26), and number of hospitals referring interhospital transfers to each receiving hospital (36 +/- 17 vs 5 +/- 7; mean +/- standard deviation; for each comparison). Statewide, "pediatric" hospitals served two thirds of all hospitalized children and 70% of all children's hospital days. "Pediatric" hospitals cared for 26.5 patients per hospital day, compared with only 2.2 per day at "other" institutions. Although statewide hospitalizations of children fell by 14.3% the proportion of all pediatric hospitalizations served by "pediatric" hospitals increased by 3.8% from 1996 to 2000.


CONCLUSIONS
Although intended for educational purposes, hospital affiliation with an accredited pediatric residency program identifies a subgroup of facilities with a distinct utilization pattern, which provides care for the majority of pediatric inpatients, and serves as a resource to other hospitals.
Kanter
Robert K
RK
Department of Pediatrics, Upstate Medical University, State University of New York, Syracuse, New York 13210, USA. kanterr@upstate.edu
Egan
Matthew
M
D006776:Hospitals, Pediatric / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D009518:New York