Contribution of birth defects and genetic diseases to pediatric hospitalizations. A population-based study

P. W. Yoon, R. S. Olney, M. J. Khoury, W. M. Sappenfield, G. F. Chavez and D. Taylor
Division of Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Ga., USA.

OBJECTIVE: To estimate the contribution of birth defects and genetic diseases to pediatric hospitalizations by use of population-based data. DESIGN: Hospital discharges were categorized according to the diagnostic codes of The International Classification of Diseases, Ninth Revision, Clinical Modification. Hospitalizations that were related to birth defects and genetic diseases were compared with hospitalizations for other reasons, with respect to age, race/ethnicity, sex, length of stay, charges, source of payment, and mortality rate. Hospitalization rates and per capita charges were computed with the use of population estimates from 1990 census data. MATERIALS: The 1991 population-based hospital discharge data from California and South Carolina. RESULTS: Nearly 12% of pediatric hospitalizations in the 2 states combined were related to birth defects and genetic diseases. These children were, on average, about 3 years younger, stayed 3 days longer in a hospital, incurred 184% higher charges, and had a 4 1/2 times greater in-hospital mortality rate than children who were hospitalized for other reasons. The rate of hospitalizations that were related to birth defects and genetic diseases was 4 per 1000 children in both states, but these rates varied by age and race. CONCLUSION: These population-based data are the first contemporary findings to show the substantial morbidity rate and hospitalization charges associated with birth defects and genetic diseases in the pediatric population. IMPLICATIONS: This information is important for planning effective health care strategies, especially as the causes, treatments, and prevention of these disorders are being further elucidated by findings from human genome research and epidemiologic studies.

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