Socioeconomic variation in discretionary and mandatory hospitalization of infants : An ecologic analysis.
To examine geographic variation in rates of infant hospitalization for diagnoses classified by type of hospitalization decision in Monroe County (Rochester), New York.
Study design was cross-sectional and ecologic.
International Classification of Diseases (ICD) codes were used to categorize all 7883 hospitalizations for infants (age,<24 months) beyond the newborn period between 1985 and 1991.
Postal zip codes defined socioeconomic areas as inner-city, other urban, and suburban for the population at risk.
In 1990, inner-city infants included 62% black and 65% Medicaid-covered infants, whereas suburban infants included 3% black and 6% covered by Medicaid.
Hospitalization rates were compared among the three socioeconomic areas.
Overall hospitalization rate was 50.3 per 1000 child years.
Admissions classified as discretionary accounted for 59% of these, followed by those classified as mandatory, 18% ; sometime (congenital heart disease, cleft palate), 15% ; discretionary surgery (inguinal hernia, tonsillectomyladenoidectomy), 6% ; and unlikely to need admission, 2%. A stepwise, socioeconomic gradient in hospitalization was found, with rates of 38.1,51.3, and 82.9 per 1000 child-years, respectively, for suburban, other urban, and inner-city areas.
Rates for discretionary, unlikely, and mandatory admissions followed this gradient. (...)
Mots-clés Pascal : Variation géographique, Statut socioéconomique, Classification, Incidence, Etats Unis, Amérique du Nord, Amérique, Morbidité, Hospitalisation, Nourrisson, Homme
Mots-clés Pascal anglais : Geographical variation, Socioeconomic status, Classification, Incidence, United States, North America, America, Morbidity, Hospitalization, Infant, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0346873
Code Inist : 002B30A01A2. Création : 12/09/1997.