title: Trends in hospitalizations and resource utilization for pediatric pertussis.
abstract: OBJECTIVE
  Pertussis is a serious and preventable childhood illness often necessitating hospitalization. The objective was to describe national trends in pediatric pertussis hospitalizations and resource utilization and factors associated with increased length of stay (LOS).
  
  
  METHODS
  This was a cross-sectional analysis of the 1997 to 2009 Healthcare Cost and Utilization Project Kids' Inpatient Databases. We examined pediatric hospitalizations of children (0-18 years) with a diagnosis of pertussis. Primary outcomes were hospitalizations, LOS, and charges. Weighted linear regression was used to evaluate trends in resource utilization. Multivariate logistic regression was used to determine factors associated with prolonged LOS.
  
  
  RESULTS
  Infants 0 to 6 months old accounted for nearly 90% of pediatric pertussis hospitalizations. Hospitalizations in public payers increased from 50% in 1997 to 67.4% in 2009 (P < .01). Among children with complex chronic conditions (CCCs), pertussis hospitalizations increased from 9.4% in 1997 to 16.8% in 2009 (P < .01). Mean LOS for pediatric pertussis hospitalizations decreased from 5.40 days in 1997 to 5.28 days in 2009 (P < .01), whereas those for children with CCCs increased from 8.86 days in 1997 to 9.25 days in 2009 (P < .01). Mean adjusted charges for pediatric pertussis hospitalizations rose from $14 520 in 1997 to $22 278 in 2009 (P < .01). For all study years, neonates and children with CCCs had greater odds of prolonged LOS.
  
  
  CONCLUSIONS
  Young infants and publicly insured patients account for a disproportionate number of pertussis-related hospitalizations. Patients with CCCs are increasingly contributing to hospitalizations and resource utilization attributable to pertussis. As new vaccine recommendations are implemented, targeted interventions are warranted to increase preventive efforts in these vulnerable populations.
authors.affiliation: Sections of Hospital Medicine malopez@texaschildrens.org.
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Lopez
authors.affiliation: Emergency Medicine Infectious Diseases.
authors.forename: Andrea T
authors.initials: AT
authors.lastname: Cruz
authors.affiliation: Academic General Pediatrics, partment of Pediatrics.
authors.forename: Marc A
authors.initials: MA
authors.lastname: Kowalkowski
authors.affiliation: Department of Medicine, Baylor College of Medicine, Houston, Texas.
authors.forename: Jean L
authors.initials: JL
authors.lastname: Raphael
mesh_terms: D002648:Child; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data / Q000639:trends*; D006801:Humans; D007902:Length of Stay; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D014917:Whooping Cough / Q000453:epidemiology / Q000628:therapy*
keywords: health services; hospitalizations; pertussis; vaccination