Volume 47 | Number 4 | August 2012

Abstract List

Richard B. Smith, Linda Dynan, Gerry Fairbrother, Glen Chabi, Lisa Simpson


To assess the association between edicaid‐induced financial stress of a hospital and the probability of an adverse medical event for a pediatric discharge.

Data Sources

Secondary data from the ationwide npatient ample, gency for ealthcare esearch and uality's ealthcare ost and tilization roject, and the merican ospital ssociation's . Study examines 985,896 pediatric discharges (children age 0–17), from 1,050 community hospitals in 26 states (representing 63 percent of the U.S. edicaid population) between 2005 and 2007.

Study Design

We estimate the probability of an adverse event, controlling for patient, hospital, and state characteristics, using an aggregated, composite measure to overcome rarity of individual events.

Principal Findings

Children in hospitals with relatively high proportions of pediatric discharges that are more reliant on edicaid reimbursement are more likely than children in other hospitals (odds ratio = 1.62) to experience an adverse event. edicaid pediatric inpatients are more likely than privately insured patients (odds ratio = 1.10) to experience an adverse event.


Hospital reliance on comparatively low edicaid reimbursement may contribute to the problem of adverse medical events for hospitalized children. Policies to reduce adverse events should account for differences in underlying, contributing factors of these events.