Recent trends in pediatric hospitalization in New York state

Objective: To describe changing rates of disorders associated with child hospitalization. Study design: Trends for the 100 diagnosis related groups (DRGs) with the largest number of hospitalizations (0-14 years) were analyzed. Results: Children were hospitalized at an average annual rate of 35 per 1000 age-specific population during 1996 to 2002. The hospitalization rate decreased by 2.3% per year. The top 100 DRGs accounted for 90% of all 949,376 child hospitalizations. Hospitalization for mental illness increased by 5.5% per year, accounting for more than 4% of all child hospitalizations in 2002. Ambulatory care-sensitive medical conditions (asthma, gastrointestinal disorders, pneumonia, seizures) continue to be leading causes of hospitalization, and they are declining no faster than the overall rate. DRGs with a significantly faster rate of decline than the overall trend included surgical procedures for which inpatient care is often unnecessary (-12.3%/year, accounting for 11% of the overall decline) trauma-related diagnoses (-4.4%/year, accounting for 7% of the overall decline), and HIV-related conditions (-31.7%/year, accounting for 3% of the overall decline). Conclusions: The rising rate of hospitalization associated with child mental illness may represent a clinically important trend. Rates of hospitalization for ambulatory care-sensitive conditions have not declined substantially despite the availability of evidence-based strategies to avoid serious illness.