title: Diarrhea-associated hospitalizations and outpatient visits among American Indian and Alaska Native children younger than five years of age, 2000-2004.
abstract: BACKGROUND
  Diarrhea accounts for many hospitalizations and outpatient clinic visits among children. American Indian and Alaska Native (AI/AN) children have experienced a greater infectious disease burden compared with the general U.S. population of children, although diarrhea-associated hospitalization rates have declined among AI/AN children.
  
  
  METHODS
  Hospital discharge and outpatient visit records with a diagnosis indicating a diarrhea-associated diagnosis were evaluated for AI/AN children <5 years of age, using the 2000-2004 Indian Health Service Direct and Contract Health Service Inpatient Data and outpatient visit data from the Indian Health Service National Patient Information Reporting System, and for the general U.S. population of children <5 years of age using the Kids' Inpatient Database for 2003 and National Ambulatory data for 2000-2004.
  
  
  RESULTS
  For 2000-2004, the diarrhea-associated hospitalization rate was similar for AI/AN children and U.S. children <5 years of age (65.9 and 79.3 of 10,000, respectively), but the rate among AI/AN infants was nearly twice the rate among U.S. infants (262.6 and 154.7 of 10,000, respectively). The rate of diarrhea-associated outpatient visits among AI/AN children was higher than for U.S. children (2255.4 versus 1647.9 of 10,000, respectively), as a result of the high rate among AI/AN infants compared with U.S. infants (6103.5 and 2956.3 of 10,000, respectively).
  
  
  CONCLUSIONS
  Although the diarrhea-associated hospitalization rate in AI/AN children <5 years old has declined to levels comparable with that of all U.S. children, the rate for AI/AN in infants remains higher than for U.S. infants. The diarrhea-associated outpatient visit rate for AI/AN children was higher than for U.S. children. Ongoing evaluation of hospitalization and outpatient data is important to understand the impact of rotavirus vaccine among AI/AN children.
authors.affiliation: Alaska Native Tribal Health Consortium, Anchorage, AK, USA. ris2@cdc.gov
authors.forename: Rosalyn J
authors.initials: RJ
authors.lastname: Singleton
authors.forename: Robert C
authors.initials: RC
authors.lastname: Holman
authors.forename: Krista L
authors.initials: KL
authors.lastname: Yorita
authors.forename: Steve
authors.initials: S
authors.lastname: Holve
authors.forename: Edna L
authors.initials: EL
authors.lastname: Paisano
authors.forename: Claudia A
authors.initials: CA
authors.lastname: Steiner
authors.forename: Roger I
authors.initials: RI
authors.lastname: Glass
authors.forename: James E
authors.initials: JE
authors.lastname: Cheek
mesh_terms: D000413:Alaska / Q000453:epidemiology; D002675:Child, Preschool; D003967:Diarrhea / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D007223:Infant; D007231:Infant, Newborn; D004930:Inuit / Q000706:statistics & numerical data*; D010045:Outpatients / Q000706:statistics & numerical data*; D012621:Seasons; D014481:United States / Q000453:epidemiology / Q000208:ethnology; D016549:United States Indian Health Service / Q000706:statistics & numerical data