Trends in resource utilization by children with neurological impairment in the United States inpatient health care system: a repeat cross-sectional study

• Published in: PLoS medicine 2012-01, Vol.9 (1), p.e1001158-e1001158
• Main Authors: Berry, Jay G, Poduri, Annapurna, Bonkowsky, Joshua L, Zhou, Jing, Graham, Dionne A, Welch, Chelsea, Putney, Heather, Srivastava, Rajendu
• Format: Article
• Language: English
• Subjects: Admission and discharge; Adolescent; Care and treatment; Child; Child, Preschool; Children & youth; Cross-Sectional Studies; Demographic aspects; Demography; Diagnosis; Female; Forecasts and trends; Health Resources - economics; Health Resources - trends; Health Resources - utilization; Hospital utilization; Hospitalization; Hospitalization - statistics & numerical data; Hospitals; Humans; Infant; Infant, Newborn; Inpatients - statistics & numerical data; Male; Medical research; Medicine; Methods; Nervous system diseases; Nervous System Diseases - diagnosis; Nervous System Diseases - epidemiology; Observational studies; Sick children; United States - epidemiology
• ISSN: 1549-1676; 1549-1277; 1549-1676
• DOI: 10.1371/journal.pmed.1001158

Care advances in the United States (US) have led to improved survival of children with neurological impairment (NI). Children with NI may account for an increasing proportion of hospital resources. However, this assumption has not been tested at a national level. We conducted a study of 25,747,016 US hospitalizations of children recorded in the Kids' Inpatient Database (years 1997, 2000, 2003, and 2006). Children with NI were identified with International Classification of Diseases, 9th Revision, Clinical Modification diagnoses resulting in functional and/or intellectual impairment. We assessed trends in inpatient resource utilization for children with NI with a Mantel-Haenszel chi-square test using all 4 y of data combined. Across the 4 y combined, children with NI accounted for 5.2% (1,338,590) of all hospitalizations. Epilepsy (52.2% [n = 538,978]) and cerebral palsy (15.9% [n = 164,665]) were the most prevalent NI diagnoses. The proportion of hospitalizations attributable to children with NI did not change significantly (p = 0.32) over time. In 2006, children with NI accounted for 5.3% (n = 345,621) of all hospitalizations, 13.9% (n = 3.4 million) of bed days, and 21.6% (US$17.7 billion) of all hospital charges within all hospitals. Over time, the proportion of hospitalizations attributable to children with NI decreased within non-children's hospitals (3.0% [n = 146,324] in 1997 to 2.5% [n = 113,097] in 2006, p