Insurance-associated disparities in hospitalization outcomes of Michigan children

J Pediatr. 2011 Feb;158(2):313-8.e1-2. doi: 10.1016/j.jpeds.2010.08.002.


Objective: To investigate whether children in Michigan with private insurance have better hospitalization-related outcomes than those with public or no insurance.

Study design: Population-based hospitalization rates were calculated for newborns and children aged <18 years in Michigan for the years 2001-2006 and stratified by age, disease grouping, and health insurance status using inpatient records from the Michigan Inpatient Database and population estimates from the US Census Current Population Survey.

Results: Michigan children with public/no insurance had significantly higher overall hospital admission rates and admission rates for ambulatory-sensitive conditions, and were more likely to be admitted through the emergency room, compared with those with private health insurance. Similarly, newborns with public/no insurance had significantly higher rates of hospitalization-related outcomes. Hospital charges per child were higher in the public/no insurance population, translating to potential excess charges of between $309.8 and $401.8 million in 2006.

Conclusions: There are disparities in health outcomes and charges between Michigan children and newborns with public/no insurance and those with private health insurance, presenting a significant opportunity to improve the efficiency and efficacy of care.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Female
  • Health Care Surveys
  • Healthcare Disparities / economics*
  • Healthcare Disparities / statistics & numerical data
  • Hospital Costs / trends*
  • Hospitalization / economics
  • Hospitalization / statistics & numerical data*
  • Humans
  • Infant
  • Infant, Newborn
  • Insurance Coverage / statistics & numerical data*
  • Insurance, Health / economics*
  • Insurance, Health / statistics & numerical data
  • Male
  • Medicaid / economics
  • Medicaid / statistics & numerical data
  • Michigan
  • Private Sector / economics
  • Private Sector / statistics & numerical data
  • Retrospective Studies
  • Socioeconomic Factors
  • United States
  • Universal Health Insurance / economics
  • Universal Health Insurance / statistics & numerical data