title: Epidemiology of pediatric hospitalizations at general hospitals and freestanding children's hospitals in the United States.
abstract: Children may be hospitalized at general hospitals or freestanding children's hospitals. Knowledge about how inpatient care differs at these hospitals is important to inform national research and quality efforts.
  
  
  
  To describe the volume and characteristics of pediatric hospitalizations at acute care general and freestanding children's hospitals in the United States.
  
  
  
  Cross-sectional study of hospitalizations in the United States among children <18 years, excluding in-hospital births, using the Healthcare Cost and Utilization Project's 2012 Kids' Inpatient Database.
  
  
  
  We examined differences between hospitalizations at general and freestanding children's hospitals, applying weights to generate national estimates. Reasons for hospitalization were categorized using a pediatric grouper, and differences in hospital volumes were assessed for common diagnoses.
  
  
  
  A total of 1,407,822 (standard deviation 50,456) hospitalizations occurred at general hospitals, representing 71.7% of pediatric hospitalizations. Hospitalizations at general hospitals accounted for 63.6% of hospital days and 50.0% of pediatric inpatient healthcare costs. Median volumes of pediatric hospitalizations, per hospital, were significantly lower at general hospitals than freestanding children's hospitals for common medical and surgical diagnoses. Although the most common reasons for hospitalization were similar, the most costly conditions differed.
  
  
  
  In 2012, more than 70% of pediatric hospitalizations occurred at general hospitals in the United States. Differences in patterns of care at general hospitals and freestanding children's hospitals may inform clinical programs, research, and quality improvement efforts. Journal of Hospital Medicine 2016;11:743-749. © 2016 Society of Hospital Medicine.
authors.affiliation: Division of Pediatric Hospital Medicine, Department of Pediatrics, Tufts Medical Center, Boston, Massachusetts. jleyenaar@post.harvard.edu.
authors.forename: JoAnna K
authors.initials: JK
authors.lastname: Leyenaar
authors.affiliation: Section of Pediatric Hospital Medicine, Department of Pediatrics, Children's Hospital at Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
authors.forename: Shawn L
authors.initials: SL
authors.lastname: Ralston
authors.affiliation: Center for Quality of Care Research, Baystate Medical Center, Springfield, Massachusetts.
authors.forename: Meng-Shiou
authors.initials: MS
authors.lastname: Shieh
authors.affiliation: Center for Quality of Care Research, Baystate Medical Center, Springfield, Massachusetts.|School of Public Health and Health Sciences, University of Massachusetts, Amherst, Massachusetts.
authors.forename: Penelope S
authors.initials: PS
authors.lastname: Pekow
authors.affiliation: Department of Pediatrics, University of Washington, Seattle Children's Research Institute, Seattle, Washington.
authors.forename: Rita
authors.initials: R
authors.lastname: Mangione-Smith
authors.affiliation: Center for Quality of Care Research, Baystate Medical Center, Springfield, Massachusetts.|Tufts University School of Medicine, Department of Medicine, Boston, Massachusetts.|Division of General Medicine, Baystate Medical Center, Springfield, Massachusetts.
authors.forename: Peter K
authors.initials: PK
authors.lastname: Lindenauer
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016638:Critical Illness / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D016208:Databases, Factual / Q000706:statistics & numerical data; D005260:Female; D006295:Health Resources; D006760:Hospitalization / Q000706:statistics & numerical data*; D006769:Hospitals, General / Q000706:statistics & numerical data*; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology