Variations in rates of hospitalization of children in three urban communities

J. M. Perrin, C. J. Homer, D. M. Berwick, A. D. Woolf, J. L. Freeman, J. E. Wennberg

Research output: Contribution to journalArticle

213 Citations (Scopus)

Abstract

Hospitalization accounts for a large portion of the expenditures for child health care, and differences in the rate of hospitalization may produce important variations in the cost of that care. We studied the rates of hospitalization in Boston, Rochester (N.Y.), and New Haven (Conn.) in 1982. We assigned the risk of hospitalization in Rochester a score of 1.00. Boston children were hospitalized at more than twice the rate of Rochester children for most medical diagnostic categories (relative risk, 2.65; 95 percent confidence interval, 2.53 to 2.78), and the rate for the New Haven group was intermediate (relative risk, 1.80; 95 percent confidence interval, 1.68 to 1.93). Rates of inpatient surgery differed less (Boston relative risk, 1.12; New Haven relative risk, 0.93). The relative risks of hospitalization (as compared with Rochester children) for Boston and New Haven children, respectively, were 3.8 and 2.3 for asthma, 6.1 and 2.9 for toxic ingestions, and 2.6 and 2.7 for head injuries. Fractures of the femur, appendicitis, and bacterial meningitis (conditions uniformly treated in the hospital) had similar rates of hospitalization across the three cities, but the relative risk of hospitalization for aseptic meningitis was 3.7 in Boston. The rates of hospitalization of children in all three communities were below the national averages in 1982. Although this study does not define the reasons for the variation in rates of hospitalization, it is possible that they were related in part to differences in socioeconomic status or access to primary care. The implications of these data for the cost and quality of pediatric care therefore remain to be determined.

Original languageEnglish (US)
Pages (from-to)1183-1187
Number of pages5
JournalNew England Journal of Medicine
Volume320
Issue number18
StatePublished - 1989
Externally publishedYes

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Hospitalization
Confidence Intervals
Aseptic Meningitis
Costs and Cost Analysis
Hospitalized Child
Bacterial Meningitides
Quality of Health Care
Poisons
Appendicitis
Child Care
Health Expenditures
Craniocerebral Trauma
Social Class
Femur
Inpatients
Primary Health Care
Asthma
Eating
Pediatrics
Delivery of Health Care

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Perrin, J. M., Homer, C. J., Berwick, D. M., Woolf, A. D., Freeman, J. L., & Wennberg, J. E. (1989). Variations in rates of hospitalization of children in three urban communities. New England Journal of Medicine, 320(18), 1183-1187.

Variations in rates of hospitalization of children in three urban communities. / Perrin, J. M.; Homer, C. J.; Berwick, D. M.; Woolf, A. D.; Freeman, J. L.; Wennberg, J. E.

In: New England Journal of Medicine, Vol. 320, No. 18, 1989, p. 1183-1187.

Research output: Contribution to journalArticle

Perrin, JM, Homer, CJ, Berwick, DM, Woolf, AD, Freeman, JL & Wennberg, JE 1989, 'Variations in rates of hospitalization of children in three urban communities', New England Journal of Medicine, vol. 320, no. 18, pp. 1183-1187.
Perrin JM, Homer CJ, Berwick DM, Woolf AD, Freeman JL, Wennberg JE. Variations in rates of hospitalization of children in three urban communities. New England Journal of Medicine. 1989;320(18):1183-1187.
Perrin, J. M. ; Homer, C. J. ; Berwick, D. M. ; Woolf, A. D. ; Freeman, J. L. ; Wennberg, J. E. / Variations in rates of hospitalization of children in three urban communities. In: New England Journal of Medicine. 1989 ; Vol. 320, No. 18. pp. 1183-1187.
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