Hospitalization of adolescents: collecting the data base. Variations and implications

A survey of 2208 adolescents (aged 12 through 18 years) hospitalized during 1977 identified variations in data-base development and unrecognized health problems. Forty-eight percent were admitted to obstetrics and gynecology, 29% to surgery, 13% to pediatrics/internal medicine combined, and 10% to psychiatry. Historical, physical, and laboratory data bases and diagnoses were examined from 325 records. All records included a history of present illness and blood pressure, and most included a past medical and family history. Excluding pediatric records, a minority of records included social, immunization, school, or perinatal histories. Pediatric records were lacking in histories of alcohol or tobacco use. Most records lacked dietary or drug-abuse histories. A majority of records contained growth parameters, hemoglobin, urinalysis, and chest x-ray. Despite a high prevalence of anemia, the diagnosis was infrequently recorded. This survey suggests that clinical departments collect data on sick adolescents in differing ways--none of which seems optimal. Clinical departments should examine their training programs regarding the collection and interpretation of the data base in order to provide optimal care for hospitalized adolescents.