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

sers of specialty-care centers statewide: 72 to 91 percent of these patients were discharged from such a center, even though there is only one, Children's Hospital Central California in Madera, serving the entire region.

Chronically ill children in this area may have been going to a specialty-care center at higher rates because they were covered by public insurance and because of the relative paucity of nearby hospitals with inpatient services, Wise said.

But in densely populated Los Angeles County, only 60 percent of chronically ill children were admitted to pediatric specialty-care centers, even though the county had by far the greatest concentration of such centers seven statewide.

This relatively low admission rate may stem from a lack of pediatric beds at the specialty-care centers, but it could also have been the result of an abundance of nearby hospitals that offer inpatient care, the researchers said. In addition to the seven specialty-care centers, there were 97 other inpatient hospitals that care for children in the county.

"I'm not sure that parents driving past a community hospital in L.A. would necessarily know that it doesn't provide the same kind of services that a children's specialty-care center would for their chronically sick child," Chamberlain said. Once their child is admitted to such a community hospital, the doctor may take into account factors unrelated to the patient's clinical condition, such as payer type and geography, in deciding whether to refer that patient to a specialty-care center, she said.

The researchers noted that among children who had chronic illnesses and who died, one in six stayed for longer than two days in a non-specialty-care center a trend they called "worrisome."

David Alexander, the president and CEO of the Lucile Packard Foundation for Children's Health and an adjunct clinical professor at the medical school, noted that one in eight U.S. children reside in Cal
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Contact: John Sanford
jsanford@stanford.edu
650-724-9175
Stanford University Medical Center
Source:Eurekalert

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