PAPER ON MEDI-CAL AND CHILDREN’S ASTHMA

Increased Asthma and Bronchiolitis Hospital Utilization Rates For Publicly Insured California Children As Compared to Those Privately Insured and Uninsured. R.B. Fox, San Jose, CA

Background and Methods To investigate the association of insurance status with per capita hospital utilization for childhood asthma, I used statewide hospital discharge rates for publicly insured California children age 0-14 for the years 1991, 1993, and 1995 adjusted for population size estimated from census data.

Results DRG 98 (Asthma and Bronchitis) comprised the largest category of hospital discharges, hospital days, and hospital charges for non-newborn children. Discharge rates for publicly insured children (98% Medi-Cal) were 75% greater than those for privately insured children in 1991 and 123% greater in 1995 while per capita hospital days were 122% and 180% greater and per capita hospital charges were 175% and 205% greater in those respective years. Utilization rates for uninsured children were similar to those for privately insured children. Similarly increased utilization rates were also found for publicly insured versus privately insured for the group of all other non-newborn non-DRG 98 discharges. For this group discharge rates for publicly insured, as compared to privately insured, children were 62% and 64% greater in 1991 and 1995 while per capita hospital days were 102% and 108% greater and per capita hospital charges were 95% and 104% greater in those respective years. Utilization rates for uninsured children for non-DRG 98, non-newborn cases were similar to those for privately insured children.

Conclusions DRG 98 hospital utilization between 1991 and 1995 for California children was two to three-fold greater for publicly insured children as compared to those privately insured. Two-fold increases were also found for the non-DRG 98 group. Utilization rates for uninsured children were similar to those for privately insured children.

 

Journal of Investigative Medicine, Vol. 47:2, p. 84A, February, 1999.