Document Detail


Increased rates of morbidity, mortality, and charges for hospitalized children with public or no health insurance as compared with children with private insurance in Colorado and the United States.
MedLine Citation:
PMID:  16882810     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: There has been a gradual decrease in the proportion of children covered by private health insurance in Colorado and the United States with a commensurate increase in those with public insurance or having no insurance which may impact access to care and outcomes. OBJECTIVE: The purpose of this work was to determine whether children with public or no health insurance have differences in hospital admission rates, morbidity, mortality, and/or charges that might be improved if standards of primary care comparable to those of children with private insurance could be achieved. METHODS: We conducted a retrospective comparison of hospitalization-related outcomes for children < 18 years of age in Colorado from 1995-2003 and in the United States in 2000. Population-based rates for hospital admission were determined stratified by age, race/ethnicity, disease grouping, and health insurance status. RESULTS: Compared with those with private insurance, children in Colorado and the United States with public or no insurance have significantly higher rates of total hospital admission, as well as admission for chronic illness, asthma, diabetes, vaccine-preventable disease, psychiatric disease, and ruptured appendix. These children have higher mortality rates, higher severity of illness, are more likely to be admitted through the emergency department and have significantly higher hospital charges per insured child. Higher hospitalization rates occur in children who are nonwhite and/or Hispanic and those who are younger. If children with public or no health insurance in the United States in 2000 had the same hospitalization outcomes as children with private insurance, $5.3 billion in hospital charges could have been saved. CONCLUSIONS: There is an opportunity to achieve improved health outcomes and decreased hospitalization costs for children with public or no health insurance if private insurance standards of health care could be achieved for all US children.
Authors:
James Todd; Carl Armon; Anne Griggs; Steven Poole; Stephen Berman
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pediatrics     Volume:  118     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-08-02     Completed Date:  2006-09-11     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  577-85     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatrics, University of Colorado School of Medicine, Denver, Colorado, USA. todd.james@tchden.org
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Child
Child, Hospitalized / statistics & numerical data*
Child, Preschool
Colorado / epidemiology
Cost-Benefit Analysis
Diagnosis-Related Groups
Ethnic Groups / statistics & numerical data
Female
Hospital Charges*
Hospital Mortality / trends*
Hospitalization / economics,  statistics & numerical data
Humans
Infant
Insurance Coverage / statistics & numerical data*
Insurance, Health / classification,  economics,  statistics & numerical data*
Male
Medical Assistance / economics,  statistics & numerical data*
Medically Uninsured / statistics & numerical data*
Minority Groups / statistics & numerical data
Morbidity / trends*
Patient Admission / statistics & numerical data
United States / epidemiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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