The introduction of the pneumococcal pneumonia vaccine into the schedule of immunizations routinely received by children in 2000 has “substantially reduced” pneumonia-related hospitalizations of both children and unvaccinated adults, according to a study in the New England Journal of Medicine. Researchers from Vanderbilt University School of Medicine compared average annual rates of pneumonia-related hospitalizations from 1997 to 1999 to rates from 2007 to 2009 using data from the Nationwide Inpatient Sample.
They found that the annual rate of hospitalization for pneumonia among children under the age of two declined by 555.1 per 100,000 children, which represents 47,000 fewer cases than expected based on the pre-vaccine rates. Reductions also were seen in the unvaccinated adult population. Overall, the researchers estimate an age-adjusted annual reduction of 54.8 per 100,000 people, or 168,000 fewer hospitalizations annually.
“The reduction in hospitalizations for pneumonia among unvaccinated persons is perhaps more remarkable than the decline among young children, who were targeted for the vaccine,” the authors state. “Indeed, older adults accounted for more than half the decline in overall hospitalizations for pneumonia.”
Breastfeeding among African Americans increased nearly 12 percentage points over the period, but whites and Hispanics continued to have higher breastfeeding rates. The American Academy of Pediatrics recommends exclusive breastfeeding for 6 months, followed by continued breastfeeding for at least 12 months as complementary foods are introduced, citing the health benefits for mothers and babies.
About 90 hospitals are participating in a CDC-funded initiative to improve breastfeeding support in hospitals. Participants in the Best Fed Beginnings collaborative work with national breastfeeding and quality improvement experts to implement 10 steps to successful breastfeeding established by the World Health Organization/UNICEF Baby Friendly Hospital Initiative.
The Centers for Medicare & Medicaid Services on Dec. 19 released its annual report summarizing state and national information on health care quality for children in the Medicaid and Children’s Health Insurance Program (CHIP). Required by the CHIP Reauthorization Act of 2009, the report provides information on state Medicaid/CHIP quality reporting as well as CMS quality initiatives.
CMS also issued a separate report describing efforts by the agency and state Medicaid programs to improve maternal and infant health outcomes by reducing early elective deliveries without a medical reason.
Mississippi has 559,653 children enrolled in Medicaid and CHIP.
Cigarette use declined to 4% from 11% among middle school youth, and to 16% from 28% among their older peers. However, the decline in cigarette smoking was slower than it was between 1997 and 2003, and cigar smoking has increased among African-American high school students. Boys were generally more likely to use tobacco than girls.
The findings are based on data from the 2011 National Youth Tobacco Survey. Smoking is the leading preventable cause of death and disease in the U.S. Nearly 90% of adult smokers begin smoking by age 18.
Total costs for children’s hospital stays were $33.6 billion, about 9% of the total costs for all patients. Pneumonia was the top reason for admission for children other than newborns, followed by asthma, acute bronchitis, and mood disorders. Skin and tissue infections were the seventh most common reason for admission, up from 13th in 2000, while flu was the 10th most common reason for admission, up from 65th in 2000.
The H1N1 flu pandemic was in effect in 2009. The estimates are based on data from the Healthcare Cost and Utilization Project Kids’ Inpatient Database.
Eighty-four percent of physicians in the Medicaid and Children’s Health Insurance Program report difficulty referring enrolled children to specialty care, according to a study released by the Government Accountability Office. Cited reasons include a short supply or long waiting list for specialists, specialists not accepting or limiting Medicaid and CHIP enrollees, low reimbursement rates and administrative issues associated with the programs, GAO said.
The findings are based on a national survey of physicians by GAO in 2010, which found 83% of primary care physicians and 71% of specialty physicians are enrolled as Medicaid and CHIP providers and serve children in those programs. According to GAO, the Department of Health and Human Services stated in comments that the report will be of value as the Centers for Medicare & Medicaid Services works with states to ensure beneficiary access to care.
The CHIP Reauthorization Act of 2009 required GAO to study children's access to care under Medicaid and CHIP.
Poor childhood health caused by environmental factors, such as air pollution and exposure to toxic chemicals, cost the United States $76.6 billion in 2008, according to a new study in the May issue of Health Affairs. This price tag represents a dramatic increase, from 2.8 percent of total health care costs in 1997 to 3.5 percent in 2008, report study authors Leonardo Trasande of the Mount Sinai School of Medicine and Yinghua Liu of National Children’s Study New York-Northern New Jersey Center.
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