Affiliations: Department of Physical Medicine and Rehabilitation,
University of Pittsburgh School of Medicine, Pittsburgh, PA, USA | Division of General Internal Medicine, Department of
Medicine, University of California San Francisco School of Medicine, San
Francisco, CA, USA | Departments of Pediatrics and Internal Medicine,
University of California San Francisco School of Medicine, San Francisco, CA,
USA
Note: [] Corresponding author: Amy J. Houtrow, 4401 Penn Ave, Pittsburgh,
PA 15224, USA. Tel.: +1 412 692 5097; Fax: +1 412 692 6462; E-mail:
houtrow@upmc.edu
Abstract: AIMS: To describe the inpatient health service use and insurance
types for hospitalized children with spina bifida compared to children
generally and to evaluate hospital discharge and insurance type trends over a
10-year study period. METHODS: The cross-sectional secondary data analyses were conducted
using the 2000, 2003, 2006 and 2009 Kid's Inpatient Databases. Diagnoses were
identified by ICD-9 codes and hospital type was categorized based on the
National Association of Children's Hospitals and Related Institutions
designations. Chi-squared tests and the Wald test of trend were used for the
statistical analyses. RESULTS: Children with spina bifida are more likely to receive their
inpatient care in children's hospitals or pediatric units compared to all
children. Children with spina bifida were most commonly admitted for shunt
malfunction and repair. The percentage of children covered by Medicaid rose
during the study period for both children with spina bifida and children
generally. CONCLUSIONS: This study is the first of its kind to document
longitudinal trends in inpatient utilization, insurance type, and reason for
admission for children with spina bifida. The changing trends in insurance
coverage should be closely monitored because insurance is closely linked to
health care access, which is linked to health outcomes.
Keywords: Spina bifida, hospital utilization, insurance type
