Volume 11, Issue 4, Pages 263-279 (July 2011) Annual Report on Health Care for Children and Youth in the United States: Focus on Trends in Hospital Use and Quality  Bernard Friedman, PhD, Terceira Berdahl, PhD, Lisa A. Simpson, MD, Bch MPH, Marie C. McCormick, MD, ScD, Pamela L. Owens, PhD, Roxanne Andrews, PhD, Patrick S. Romano, MD, MPH  Academic Pediatrics  Volume 11, Issue 4, Pages 263-279 (July 2011) DOI: 10.1016/j.acap.2011.04.002 Copyright © 2011 Terms and Conditions

Figure 1 Hospital discharge rates for leading diagnostic groups, children aged 1 to 4 years. Sources: Weighted national estimates from Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS), 2000 to 2007, Agency for Healthcare Research and Quality; population data by age group derived from published US census tables. Academic Pediatrics 2011 11, 263-279DOI: (10.1016/j.acap.2011.04.002) Copyright © 2011 Terms and Conditions

Figure 2 Hospital discharge rates for leading diagnostic groups, children aged 5 to 9 years. Sources: Weighted national estimates from HCUP NIS, 2000 to 2007, Agency for Healthcare Research and Quality; population data by age group derived from published US census tables. Academic Pediatrics 2011 11, 263-279DOI: (10.1016/j.acap.2011.04.002) Copyright © 2011 Terms and Conditions

Figure 3 Hospital discharge rates for leading diagnostic groups, children aged 10 to 14 years. Sources: Weighted national estimates from HCUP NIS, 2000 to 2007, Agency for Healthcare Research and Quality; population data by age group derived from published US census tables. Academic Pediatrics 2011 11, 263-279DOI: (10.1016/j.acap.2011.04.002) Copyright © 2011 Terms and Conditions

Figure 4 Hospital discharge rates for leading diagnostic groups, children aged 15 to 17 years. Sources: Weighted national estimates from HCUP NIS, 2000 to 2007, Agency for Healthcare Research and Quality; population data by age group derived from published US census tables. Academic Pediatrics 2011 11, 263-279DOI: (10.1016/j.acap.2011.04.002) Copyright © 2011 Terms and Conditions

Figure 5 Principal diagnosis of skin and subcutaneous infections, rate per 100 000. Sources: Weighted national estimates from HCUP NIS, 2000 to 2007, Agency for Healthcare Research and Quality; population data by age group derived from published US census tables. Academic Pediatrics 2011 11, 263-279DOI: (10.1016/j.acap.2011.04.002) Copyright © 2011 Terms and Conditions

Figure 6 Payer proportion for children in short-stay hospitals, aged 0 to 17 years. Sources: Weighted national estimates from HCUP NIS, 2000 to 2007, Agency for Healthcare Research and Quality; population data by age group derived from published US census tables. Academic Pediatrics 2011 11, 263-279DOI: (10.1016/j.acap.2011.04.002) Copyright © 2011 Terms and Conditions

Figure 7 Percentage of children with an inpatient (IP) hospital stay over time. Data from the Medical Expenditure Panel Survey Full-year Consolidated files 2000 (HC-050), 2001 (HC-060), 2002 (HC-070), 2003 (HC-079), 2004 (HC-089), 2005 (HC-097), 2006 (HC-105), and 2007 (HC-113). T test comparing estimates in 2000 to 2007 showed no statistically significant differences at P < .05. Academic Pediatrics 2011 11, 263-279DOI: (10.1016/j.acap.2011.04.002) Copyright © 2011 Terms and Conditions

Figure 8 Percentage of children with IP visit by insurance status over time. Data from the Medical Expenditure Panel Survey Full-year Consolidated files 2000 (HC-050), 2001 (HC-060), 2002 (HC-070), 2003 (HC-079), 2004 (HC-089), 2005 (HC-097), 2006 (HC-105), and 2007 (HC-113). T test comparing estimates in 2000 to 2007 showed no statistically significant differences at P < .05. Estimates of use for uninsured children are not included for 2001, 2004 to 2006 due to sample sizes <100. Estimates for any private compared with public insurance in 2000 and 2007 were statistically significant at P < .05. Academic Pediatrics 2011 11, 263-279DOI: (10.1016/j.acap.2011.04.002) Copyright © 2011 Terms and Conditions

Figure 9 Average annual total expenditures for children with an emergency, inpatient or outpatient hospital visit by age group. Data for this chart come from the Medical Expenditure Panel Survey Full-year Consolidated files 2000 (HC-050), 2001 (HC-060), 2002 (HC-070), 2003 (HC-079), 2004 (HC-089), 2005 (HC-097), 2006 (HC-105), and 2007 (HC-113). T test comparing estimates in 2000 to 2007 showed no statistically significant differences at P < .05. The difference between 2000 and 2007 for children aged 5 to 9 years was statistically significant at P < .10. Academic Pediatrics 2011 11, 263-279DOI: (10.1016/j.acap.2011.04.002) Copyright © 2011 Terms and Conditions

Figure 10 Potentially avoidable conditions, acute (gastroenteritis, urinary tract infections) per 100 000 population aged 5 to 17 years, adjusted for age and gender. Source: HCUP NIS and Quality Indicators, version 3.1, 2000 to 2007, Agency for Healthcare Research and Quality. Academic Pediatrics 2011 11, 263-279DOI: (10.1016/j.acap.2011.04.002) Copyright © 2011 Terms and Conditions

Figure 11 Potentially avoidable conditions, chronic (asthma, diabetes) per 100 000 population aged 5 to 17 years, adjusted for age and gender. ∗Significant downward trend of weighted regression; P < .05. Source: HCUP Nationwide Inpatient Sample and Quality Indicators, version 3.1, 2000 to 2007, Agency for Health care Research and Quality. Academic Pediatrics 2011 11, 263-279DOI: (10.1016/j.acap.2011.04.002) Copyright © 2011 Terms and Conditions

Figure 12 Potentially Avoidable Conditions, Chronic, per 100 000 Population, Age 5 to 17, Adjusted for Age and Gender. ∗Significant decline, 2000 to 2007; P < .05. Source: HCUP NIS and Quality Indicators, version 3.1, 2000 to 2007, Agency for Healthcare Research and Quality. Academic Pediatrics 2011 11, 263-279DOI: (10.1016/j.acap.2011.04.002) Copyright © 2011 Terms and Conditions

Figure 13 Trend of patient safety for hospitalized children: postoperative complications calibrated to each begin at 100 in year 2000. ∗Significant decline, 2000 to 2007; P < .01. Source: HCUP NIS and Quality Indicators, version 3.1, 2000 to 2007, Agency for Healthcare Research and Quality. Academic Pediatrics 2011 11, 263-279DOI: (10.1016/j.acap.2011.04.002) Copyright © 2011 Terms and Conditions

Figure 14 Trend of patient safety for hospitalized children: medical and surgical complications calibrated to each begin at 100 in year 2000. ∗Significant increase, 2000 to 2007; P < .01. ∗∗Significant decrease, 2000 to 2007; P < .01. Source: HCUP NIS and Quality Indicators, version 3.1, 2000 to 2007, Agency for Healthcare Research and Quality. Academic Pediatrics 2011 11, 263-279DOI: (10.1016/j.acap.2011.04.002) Copyright © 2011 Terms and Conditions

Figure 15 Accidental puncture or laceration during procedure per 1000 discharges (excluding obstetric admissions, normal newborns, and neonates with a birth weight <500 g). Adjusted by gender within age group. Also excludes admissions specifically for problems such as cases from earlier admissions or from other hospitals. Significant increases for age groups 10 to 14 years and 15 to 17 years; P < .01. Source: HCUP NIS and Quality Indicators, version 3.1, 2000 to 2007, Agency for Healthcare Research and Quality. Academic Pediatrics 2011 11, 263-279DOI: (10.1016/j.acap.2011.04.002) Copyright © 2011 Terms and Conditions

Figure 16 Iatrogenic pneumothorax per 1000 discharges (excludes neonates with a birth weight < 2500 g, and patients with chest trauma or thoracic procedures) Adjusted by age and gender. Also excludes admissions specifically for iatrogenic pneumothorax, such as cases from earlier admissions or from other hospitals. Includes barotrauma (including acute respiratory distress syndrome) and central line placement. ∗Significant decline, 2000 to 2007; P < .01. Source: HCUP NIS and Quality Indicators, version 3.1, 2000 to 2007, Agency for Healthcare Research and Quality. Academic Pediatrics 2011 11, 263-279DOI: (10.1016/j.acap.2011.04.002) Copyright © 2011 Terms and Conditions