PEDIATRICS Vol. 101 No. 4 April 1998, p. e13
Received Sep 4, 1997; accepted Dec 16, 1997.
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From * District Four Health Services, LaGrange, Georgia; and the
Departments of
Health Services, § Pediatrics, and
Epidemiology,
University of Washington, Seattle, Washington.
Objective. To determine whether length of stay (LOS) for asthma admissions at a local university-affiliated children's hospital (UACH) is similar to that of community hospitals within the same county.
Methods. A retrospective analysis was performed
using computerized hospital abstract records from 1989 through 1994. The study population was children 1 to 18 years old whose first or only hospitalization for a primary diagnosis of asthma occurred during the
study period at either the UACH or one of the 17 community hospitals in
King County, WA, that admit pediatric patients (n = 2491).
Transfers and patients with chronic obstructive asthma or secondary
diagnoses such as cystic fibrosis were not included in the study.
Asthma patients were compared by sociodemographic and health risk
characteristics such as age, sex, insurance status, and a comorbidity
severity score. Differences between the two hospital populations were
tested by
2 and t tests. The effect of
hospitalization at the UACH or the community hospitals on LOS was
determined using analysis of covariance after adjusting for the
sociodemographic and health risk covariates.
Results. Sixty-two percent (62%) of the asthma patients in the study population were discharged from the UACH. Compared with patients discharged from the community hospitals, the UACH patients were significantly younger, more often male, used public insurance, and resided in areas with lower median household incomes. The severity of comorbidities was not different between the two hospital groups. Overall, adjusted mean LOS was not significantly longer at the UACH (2.1 days) than at the community hospitals (2.0 days); however, adjusted mean LOS for specific subgroups, most notably poor children and those with public insurance, was significantly longer at the UACH.
Conclusion. LOS for first or only asthma hospitalizations during 1989 through 1994 at the UACH was similar to local community hospitals within the same county. Specific subgroups of children were hospitalized for a longer period at the UACH, but children with private insurance and from areas with higher median household incomes had similar LOS, and presumably costs, at the UACH and the community hospitals.
Key words: length of stay, asthma, children's hospital.