Insurance-associated disparities in hospitalization outcomes of Michigan children.
OBJECTIVE
To investigate whether children in Michigan with private insurance have better hospitalization-related outcomes than those with public or no insurance.


METHODS
Population-based hospitalization rates were calculated for newborns and children aged <18 years in Michigan for the years 2001-2006 and stratified by age, disease grouping, and health insurance status using inpatient records from the Michigan Inpatient Database and population estimates from the US Census Current Population Survey.


RESULTS
Michigan children with public/no insurance had significantly higher overall hospital admission rates and admission rates for ambulatory-sensitive conditions, and were more likely to be admitted through the emergency room, compared with those with private health insurance. Similarly, newborns with public/no insurance had significantly higher rates of hospitalization-related outcomes. Hospital charges per child were higher in the public/no insurance population, translating to potential excess charges of between $309.8 and $401.8 million in 2006.


CONCLUSIONS
There are disparities in health outcomes and charges between Michigan children and newborns with public/no insurance and those with private health insurance, presenting a significant opportunity to improve the efficiency and efficacy of care.
Peterson
Thomas H
TH
Department of Quality, Helen DeVos Children's Hospital, Grand Rapids, MI, USA. tom.peterson@spectrum-health.org
Peterson
Tom
T
Armon
Carl
C
Todd
James
J
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D019538:Health Care Surveys; D054625:Healthcare Disparities / Q000191:economics* / Q000706:statistics & numerical data; D017721:Hospital Costs / Q000639:trends*; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019458:Insurance Coverage / Q000706:statistics & numerical data*; D007348:Insurance, Health / Q000191:economics* / Q000706:statistics & numerical data; D008297:Male; D008484:Medicaid / Q000191:economics / Q000706:statistics & numerical data; D008824:Michigan; D017149:Private Sector / Q000191:economics / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D014481:United States; D019472:Universal Health Insurance / Q000191:economics / Q000706:statistics & numerical data