For Release: May 16, 2005
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Study Shows Non-Children's Hospitals Serve Majority of U.S. Children

Dartmouth Medical School
Dr. David Goodman

HANOVER, NH - A study comparing U.S. pediatric hospitalizations showed that only one-third of a total 1.7 million hospitalizations in the year 2000 were to children's hospitals with specialized pediatric expertise. The results were presented at the 2005 Pediatric Academic Societies' Annual Meeting in Washington DC on May 15.

"We were surprised at the high proportion of pediatric hospitalizations at non-children's hospitals," said Dr. David Goodman, professor of pediatrics and of community and family medicine at Dartmouth Medical School. "We also found that non-children's hospitals also care for a disproportionate number of poor and uninsured pediatric patients."

The researchers 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.

Dartmouth Medical School

"This study is the first detailed look at this set of issues, providing a picture of different institutional burdens," said Dr. Richard Wasserman, professor of pediatrics at University of Vermont and 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."

"Do we need more children's hospitals or do we need to build greater expertise in community hospitals? This is the fundamental question that the health care community needs to answer to improve care for hospitalized children," added Goodman, also a specialist in pediatric allergy at the Children's Hospital at Dartmouth.

The group now plans to examine pediatric emergency department use at non-children's hospitals. In addition to Wasserman and Goodman, members of the study team include Pamela Owens, PhD, Anne Elixhauser, PhD, and Denise Remus, PhD, from the U.S. Health and Human Services' Agency for Healthcare Research and Quality.


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