National Estimates of Pediatric Infectious Disease Hospitalizations from 1997-2009: An Analysis of the Kids' Inpatient Database

Background.  Infectious diseases are a major source of morbidity and mortality in children. In this study, we sought to identify and generate national estimates of the primary infectious disease diagnoses associated with pediatric hospitalizations.

Methods.  We analyzed a nationwide, stratified probability sample of hospital discharges among children <18 years that was weighted using a complex survey design to 36.3 million discharges over a five year period, including: 1997, 2000, 2003, 2006, and 2009. Primary infectious disease discharge diagnoses were identified using the Clinical Classification Software and Major Diagnostic Categories, which were developed for use with the Healthcare Cost and Utilization Project (HCUP) Kids' Inpatient Database.

Results.  Annually, 687,000 of 7.3 million (9.4%) pediatric discharges were associated with a primary infectious disease diagnosis. The proportion of pediatric hospitalizations with a primary infectious disease discharge diagnosis decreased from 11.2 to 8.8% from 1997 to 2009 ( P < 0.001). After newborn deliveries, infectious diseases were the leading cause of pediatric hospitalization. Eight conditions accounted for more than 80% of pediatric infectious disease discharge diagnoses (table). Respiratory tract infections accounted for 63% of all pediatric infectious disease hospitalizations.

Conclusion.  Infectious diseases are a leading cause of pediatric hospitalizations, led by pneumonia and bronchiolitis. Infectious disease diagnoses were the primary diagnosis for approximately 10% of all pediatric hospitalizations and a substantial proportion of health expenditures.