Because of care advances, more infants and children with previously lethal health problems are surviving. Many, however, are left with lifelong neurologic impairment. A Children's Hospital Boston study of more than 25 million pediatric hospitalizations in the U.S. now shows that neurologically impaired children, though still a relatively small part of the overall population, account for increasing hospital resources, particularly within children's hospitals. Their analysis, based on data from the Agency for Healthcare Research and Quality Kids' Inpatient Database (KID), was published online January 17th in PLoS Medicine.
The researchers analyzed KID data from 1997, 2000, 2003 and 2006, encompassing 25.7 million hospitalizations of children age 0 to 18. Of these, 1.3 million hospitalizations were for children with neurologic conditions, primarily cerebral palsy and epilepsy.
During the 10-year period, children with neurologic diagnoses were admitted more to children's hospitals and less to community hospitals. At non-children's hospitals, they made up a falling share of admissions (from 3 percent in 1997 to 2.5 percent in 2006); at children's hospitals, they made up a rising share (from 11.7 percent of admissions in 1997 to 13.5 percent in 2006).
Within children's hospitals, neurologically impaired children accounted for an increasing proportion of resources: In 2006, they accounted for 25 percent of all bed days (up from 21.8 percent in 1997) and 29 percent of hospital charges ($12 billion, up from 27 percent in 1997).
"Our findings suggest that children's and non-children's hospitals are caring for increasingly different populations of children," says first author Jay Berry, MD, MPH, an attending physician in the Complex Care Service at Children's Hospital Boston. "Children with neurologic impairment tend to require expensive, lengthy hospitalizations. As policymakers increasingly focus on healthcare costs, we mus
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