Wasserman and colleagues examined data from the 2000 Healthcare Cost and Utilization Project Kids' Inpatient Database for the study. The team found that a total of 64.4 percent of hospitalizations for children ages 1 to 17 were to non-children's hospitals. More than one in 20 of these hospitalizations was for a mental health admission. When compared to discharges in children's hospitals (defined by the National Association of Children's Hospitals and Related Institutions as primarily organized and operated for the care of children and youth), significantly more discharges in non-children's hospitals were for 15- to 17-year-old females, patients from low-income zip codes, and uninsured patients.
"This study is the first detailed look at this set of issues, providing a picture of different institutional burdens," said Wasserman, the study's lead investigator. "While our results do not assess quality of care, we hypothesize that non-children's hospitals may be under-resourced in pediatric expertise while providing an excess of care for the poor and for mental health conditions."
The group next plans to examine pediatric emergency department use at non-children's hospitals. In addition to Wasserman, members of the study team include Pamela Owens, Ph.D., Anne Elixhauser, Ph.D., and Denise Remus, Ph.D., R.N., from the U.S. Health and Human Services' Agency for Healthcare Research and Quality; and David Goodman, M.D., from the Center for the Evaluative Clinical Sciences at Dartmouth Medical School.