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Objective: To estimate the contribution of birth defects and genetic diseases to pediatric hospitalizations by use of population-based data. Design: Hospital discharges were categorized according to the diagnostic codes of The International Classification of Diseases, Ninth Revision, Clinical Modification. Hospitalizations that were related to birth defects and genetic diseases were compared with hospitalizations for other reasons, with respect to age, race/ethnicity, sex, length of stay, charges, source of payment, and mortality rate. Hospitalization rates and per capita charges were computed with the use of population estimates from 1990 census data. Materials: The 1991 population-based hospital discharge data from California and South Carolina. Results: Nearly 12% of pediatric hospitalizations in the 2 states combined were related to birth defects and genetic diseases. These children were, on average, about 3 years younger, stayed 3 days longer in a hospital, incurred 184% higher charges, and had a 4 1/2 times greater in-hospital mortality rate than children who were hospitalized for other reasons. The rate of hospitalizations that were related to birth defects and genetic diseases was 4 per 1000 children in both states, but these rates varied by age and race. Conclusion: These population-based data are the first contemporary findings to show the substantial morbidity rate and hospitalization charges associated with birth defects and genetic diseases in the pediatric population. Implications: This information is important for planning effective health care strategies, especially as the causes, treatments, and prevention of these disorders are being further elucidated by findings from human genome research and epidemiologic studies. Arch Pediatr Adolesc Med. 1997;151:1096-1103, Birth defects make a substantial contribution to hospital costs in children. Analysis of hospital discharge data in 1991 in South Carolina and California revealed that birth defects and genetic disorders accounted for 12% of children's hospitalizations in both states combined. Children with birth defects or genetic disorders stayed longer in the hospital compared to other children and their hospital charges were 184% higher. Mortality rates in these children were four times greater than in children with other diseases.

To examine the descriptive epidemiology of serious measles complications and associated hospital costs during a major epidemic, we used California population-based hospital discharge data to identify hospital admissions for measles during 1986 through 1990 (ICD-9 code 055, n = 4,201). We examined 5-year trends and, for 1990 pediatric epidemic cases (n = 2,234), sociodemographic and hospital admission financial data. Hospital admission rates for measles rose significantly between 1986 and 1990. During the 1990 epidemic, preschool children aged 1 to 5 years, Medi-Cal (California's Medicaid) beneficiaries, Hispanics, and those living in urban counties accounted for most hospital admissions. Young infants and residents of southern California and the San Joaquin Valley had the highest risks. Medi-Cal beneficiaries and Asian children were at an increased risk for death during the hospital stay. The average hospital admission cost was $8,201, and the average length of hospital stay was 4.6 days. Hospital costs amounted to $18 million, two thirds of which was paid for by Medi-Cal. Measles is a serious disease that can result in severe complications requiring lengthy and costly hospital stays. We must remain alert to its continuing threat, complications, and resulting financial burdens., (Chavez GF, Ellis M: Pediatric hospital admissions for measles--Lessons from the 1990 epidemic. West J Med 1996; 165:20-25) Despite a dramatic 98% decrease in the number of measles cases since [...]

We conducted a retrospective analysis of 1992 hospital discharge data to determine the incidence of mental illness hospitalizations among elementary-school-aged children and to analyze differences in hospital use by selected population characteristics. We analyzed population-based records of hospitalizations of 6- to 12-year-olds (n = 4,460) with a principal diagnosis of mental illness and calculated relative risks (RRs) for hospitalization by sex, race/ethnicity, and payment source. Mental illnesses accounted for 8.1% of hospitalizations and 28.9% of hospital days for 6- to 12-year-olds. Hospital charges totaled $85 million. Boys had a higher risk of mental illness hospitalization than girls (RR 1.96; 95% confidence interval [CI] 1.84-2.08). Latino children had a lower risk than whites (RR 0.22; 95% CI 0.20-0.24), as did children in the 'Asian/other' group (RR 0.12, 95% CI 0.10-0.15). Inpatient hospitalizations for mental illness have a major impact on hospital morbidity for elementary-school-age children. Boys are overrepresented and Latinos and Asians/others are underrepresented among mental illness hospitalizations. Clinical implications for these findings and barriers to the delivery of inpatient mental health care are discussed. (Chabra A, Chavez GF, Harris ES. Mental illness in elementary-school-aged children. West J Med 170:28-34), The mental health needs of children in the United States remain largely unmet or underserved.[1,2] Prevalence estimates in both industrialized and developing countries suggest that as many as 14% to [...]

To compute ratios of severe pregnancy complications (the number of hospitalizations for pregnancy complications per 100 deliveries) and to examine factors associated with their prevalence.