Many patients with chronic childhood diseases are now living to be adults. Some continue to use pediatric hospitals, despite recommendations by medical associations that they transition into adult-care systems. This study examined hospital use, including length of stay (LOS) and incurred hospital charges, by adults suffering from four pediatric-onset chronic diseases: complex congenital heart disease (CCHD), cystic fibrosis (CF), spina bifida (SB) and sickle cell disease (SCD). Data came from the 2002 Nationwide Inpatient Sample (NIS), the largest publicly available all-payer inpatient database in the U.S.
Limitations of the study include the inability to determine which, if any, of the above hypotheses are correct; the study is observational and not prospective, and not all confounding factors can be accounted for; data in the NIS are based on discharges and therefore readmission rates cannot be assessed, which could mean that longer LOS results in fewer readmissions might result in annual per person charges being lower than they appear in this study. Further research should focus on how these differences translate into differences in care quality, decreased morbidity, or future savings.