A comparison of long pediatric hospitalizations in 1985 and 1994.

The objective of this study was to identify pediatric conditions commonly resulting in long hospitalizations, to evaluate changes in hospital use for these conditions over a 9-year period, and to describe the characteristics of children hospitalized for long periods (longer than 7 days). To accomplish this purpose we conducted a population-based, descriptive analysis of pediatric hospitalizations for children aged 1 to 12 years in California in 1985 and 1994 using hospital discharge data. We found that hospitalizations of longer than 7 days accounted for 10.8% of pediatric hospitalizations in 1985 (58.4% of pediatric hospital days) and 11.8% of hospitalizations in 1994 (50.4% of hospital days). Rates of long pediatric hospitalization decreased from 312.1/100,000 children in 1985 to 236.4/100,000 children in 1994. Rates fell for both sexes, in all racial/ ethnic groups, and among both preschool-age and school-age children. Common reasons for long hospitalizations in both 1985 and 1994 included lower-limb fractures, pneumonia, appendicitis, and malignancies. The rate of long hospitalization for mental disorders increased by 57% between 1985 and 1994, while the rate for injuries and poisoning decreased by 38%. In summary, long pediatric hospitalizations in 1985 and 1994 accounted for under 12% of all hospitalizations of children but for more than 50% of all hospital days. Although the overall rate of long pediatric hospitalizations decreased, rates for certain conditions, notably mental disorders, increased. As states continue to implement major health care changes, further study of conditions among children that account for a large proportion of hospital days is warranted.