First Report in a Decade Quantifies Healthcare for U.S. Children

Taking a comprehensive look at healthcare delivery to children for the first time in more than a decade, a report by the Harvard School of Public Health’s Center for Children’s Health and the U.S. Agency for Healthcare Research and Quality (AHRQ) has found that asthma, injuries and mental health problems are the leading causes of hospitalization of children over 5 years old.

Infections and birth-related problems send more preschoolers and infants to the hospital, while youths aged 15 to 17 are hospitalized primarily for problems related to pregnancy and childbearing.

These are among the findings of the first in a new series of annual reports on how children and youth are receiving health care in the United States. The report, based on new, national surveys conducted by AHRQ, was published in a special supplement of Pediatrics titled the “Journal of the Ambulatory Pediatric Care Association.”

The reports are intended “to provide timely information in this era of rapid changes in the healthcare system,” said Marie C. McCormick, lead author and director of the Harvard Center for Children’s Health at the School of Public Health.

While Medicare data provides up-to-date information on many aspects of care for the elderly, estimates of expenditures and service use for children have relied on data that was over a decade old.

“We hope that this series of reports will stimulate new research using these data to understand the situation facing children, a situation which differs in many ways from that of adults,” said McCormick. “We also hope that these reports will serve as a basis for advocacy to improve access to health care for children.”

Findings include:

• Infection is the diagnosis for 41.5 percent of hospitalizations for children aged 1 to 4.

• Pregnancy and delivery accounts for 30.1 percent of hospitalizations for children aged 15 to 17.

• Hispanic children were the racial/ethnic group most likely to be uninsured (21.2 percent).

• The average charge for each hospital episode for children and youth was about half that for adults ($5,284 vs. $11,787)

• Fewer than half of all children and adolescents had a dental care visit in 1996.

Copies of the Annual Report on Access to and Utilization of Health Care for Children and Youth in the United States 1999 are available without charge from the AHRQ Publications Clearinghouse, P.O. Box 8547, Silver Spring, Md. 20907; telephone: (800) 358-9295, and from AHRQ InstantFax (301) 594-2800.