Pediatric acquired immunodeficiency syndrome hospitalizations in New Jersey.

This study examines all acquired immunodeficiency syndrome (AIDS) hospitalizations during 1987 for children younger than 13 years of age in New Jersey, with the AIDS diagnosis confirmed through a match with the state AIDS Registry. Days of hospitalization and cost for 318 admissions and annual utilization measures for the 74 children in the sample were analyzed by sex, age, race/ethnicity, hospital, discharge status, payer, and a severity-of-illness proxy. These measures were also compared with those for 3152 admissions of 1623 New Jersey adolescents and adults with AIDS hospitalized during 1987. Children with AIDS averaged 14.09 days and $8636 per admission, 4.35 admissions per year, and 60.96 days of hospitalization per year at an average cost of $37,110. The severity-of-illness proxy was the best predictor of hospital utilization and mortality. Hospitals varied widely in their proportions of very short and very long stays that signal possibly inappropriate utilization. Medicaid patients had relatively high utilization measures, and Hispanic children, relatively low measures. Per-admission utilization of children was similar to that of adults, but annual hospital utilization was significantly higher for children. Reimbursable outpatient and home care services appear to reduce inappropriate utilization.