Magazine article Clinical Psychiatry News

Neurologic Burden Rises at Children's Hospitals

Magazine article Clinical Psychiatry News

Neurologic Burden Rises at Children's Hospitals

Article excerpt

FROM PLOS MEDICINE

Children with neurologic impairment - especially epilepsy - accounted for more than 21% of all hospital charges in 2006, and their impact on children's hospitals is growing as utilization shifts to those facilities, according to a retrospective, cross-sectional analysis of the Kids' Inpatient Database.

The institutions must make sure they provide adequate staffing and education to treat these vulnerable children, Dr. Jay G. Berry of Children's Hospital Boston and his coauthors recommended. They analyzed data from more than 25.7 million hospitalizations in 1997, 2000, 2003, and 2006 in the Kids' Inpatient Database.

They found that the proportion of hospitalizations attributable to children with neurologic impairment (5.3% in 2006) did not change significantly over time (PLoS Med. 2012 Jan. 17 [doi: 10.1371/journal.pmed. 1001158]).

But although children with neurologic impairment represented fewer than 6% of admissions during that period, they accounted for a significant rise in the proportion of hospital bed days (from 12.9% in 1997 to 13.9% in 2006).

During 1997-2006, the proportion of hospitalizations attributable to children with neurologic impairment decreased within non-children's hospitals (from 3% to 2.5%), but increased within children's hospitals from 11.7% to 13.5%. The proportion of bed days at children's hospitals for such children also grew (from 21.8% to 25.0%), and their proportion of hospital charges rose from 27.1% to 29.0%.

More than 52% of admissions involved a diagnosis of epilepsy. Almost 16% involved a diagnosis of cerebral palsy.

Dr. Jeffrey Buchhalter, pediatric neurologist at Phoenix Children's Hospital, said in an interview that the study provides real data on trends that he's seen in his own institution.

"It's confirmed ... that these are very frequent admissions and very expensive admissions" he said. …

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