Date and Time
October 17, 2007
1:30 PM - 3:00 PM

Availability
Open to the public
No RSVP required

Speaker
David Krodel - Medical School Student at Stanford University

Our objective is to determine the degree to which children with special health care needs depend on hospitals receiving Disproportionate Share Hospital (DSH) funds. We have performed a retrospective analysis of California's statewide discharge dataset maintained by the Office of Statewide Health Policy and Development (OSHPD), examining all discharges from California hospitals between 1998 and 2004 of children less than 20 years of age and determined whether that hospital received DSH funds for that year.

We correlated discharges from DSH hospitals with patient characteristics such as health status, race, and type of insurance. During this time, the pediatric admission rate to DSH-funded, privately-owned hospitals increased by 28%, while admissions at the non-DSH-funded, privately owned hospitals decreased by a similar number. Chronically ill children reflected these trends.

However, other at-risk groups such as Black and Hispanic children were admitted to DSH-funded hospitals at a rate 2 to 3 times higher than those of White children, while the opposite was true for admission rates to non-DSH-funded, privately-owned hospitals. Children that have private insurance are about twice as likely to be admitted to hospitals not receiving DSH funding than children that have public insurance. Both chronically ill and acutely ill children are heavily dependent on care from hospital receiving DSH funding.

Of all children, subgroups that rely heavily on DSH-funded hospitals include racial minorities such as Black and Hispanic children as well as those who rely mainly on public insurance such as Medi-Cal. While imperfect, the DSH funding system supports institutions that care for the most vulnerable children and this must be carefully considered before radically changing this funding system.