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Stanford/Packard study finds surprising disparity in where chronically ill kids hospitalized
Date:6/2/2010

STANFORD, Calif. Chronically ill children with private insurance are much less likely than those with public insurance, such as Medi-Cal, to be admitted to a California hospital offering specialized pediatric care, according to a new study by researchers at Lucile Packard Children's Hospital and the Stanford University School of Medicine.

The study also shows that the likelihood of a chronically ill child being admitted to a specialty-care center varies wildly across the state. For example, chronically ill children in San Francisco and San Mateo counties were far more likely to be hospitalized at a pediatric specialty-care center than their counterparts just across the bay in Sonoma and Napa.

These findings and several others in the study suggest that decisions about whether to refer a chronically ill child to a pediatric specialty-care hospital are in many cases driven by factors other than medical need. The study appears in the June issue of Pediatrics, which is also available online at http://pediatrics.aappublications.org.

In examining hospital-discharge data from 1999 to 2007, the researchers concluded that the state's health leaders urgently need to review the policies and practices that determine where chronically ill kids are hospitalized. "There does not appear to be a coordinated and coherent system," said Paul Wise, MD, MPH, the study's senior author. "We were expecting some variation, but not this much."

Pediatric specialty-care centers offer high levels of intensive care and a variety of clinical subspecialties. There are about 20 of these centers in California, including Santa Barbara Cottage Hospital and Riverside County Regional. Eight of these centers offer the most comprehensive range of services and are accredited as children's hospitals, among them Packard Children's.

In 2007, pediatric beds at specialty-care centers were occupied 67 perce
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Contact: John Sanford
jsanford@stanford.edu
650-724-9175
Stanford University Medical Center
Source:Eurekalert

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