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Pediatric acquired immunodeficiency syndrome hospitalizations in New Jersey
R Conviser1, C M Grant, M J Coye
1Oregon Health Sciences University, Portland.
Insights
Children with acquired immunodeficiency syndrome (AIDS) had higher annual hospitalizations than adults, with severity of illness impacting utilization. Outpatient and home care services may reduce inappropriate hospital use.
Area of Science:
- Pediatric Health
- Epidemiology
- Healthcare Management
Background:
- Acquired immunodeficiency syndrome (AIDS) significantly impacts pediatric populations, necessitating analysis of healthcare utilization.
- Understanding hospitalization patterns in children with AIDS is crucial for resource allocation and care planning.
Purpose of the Study:
- To analyze hospitalization days, costs, and annual utilization for children under 13 with AIDS in New Jersey during 1987.
- To compare pediatric AIDS hospitalization data with that of adolescents and adults.
Main Methods:
- Retrospective analysis of all AIDS hospitalizations for children (<13 years) in New Jersey, 1987.
- Data linkage with the state AIDS Registry for confirmed diagnoses.
- Comparison of pediatric data with 3152 admissions of 1623 adolescents and adults with AIDS.
Main Results:
- Children with AIDS averaged 14.09 days/$8636 per admission and 60.96 days/$37,110 annually.
- Severity of illness was the strongest predictor of hospital utilization and mortality.
- Children exhibited higher annual hospital utilization than adults, with Medicaid patients showing high utilization and Hispanic children showing lower measures.
Conclusions:
- Pediatric AIDS hospitalizations present unique utilization patterns compared to adults, particularly in annual measures.
- Hospital length of stay variations suggest potential for inappropriate utilization.
- Accessible outpatient and home care services may mitigate excessive hospital use in pediatric AIDS patients.
Abstract:
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.
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