"Anxiety" May Help Drive an Overrepresentation of White Children Among Hospital Admissions

More isn't always better when it comes to hospital admissions. In a study that controlled for severity of illness, white youth were found to be twice as likely to be admitted to the hospital for a minor illness than minority children.

The gap appears when national admissions data studied by researchers are broken down into quintiles by severity for whites and for minorities, reported James M. Chamberlain, MD, of Children's National Medical Center in Washington, D.C. at a talk here today. Minorities are admitted at an "appropriate level" across the spectrum of severity, Dr. Chamberlain pointed out, but "whites were twice as likely as minorities to be admitted for medical issues on the mild end of the spectrum of severity."

Overall, noted Dr. Chamberlain, approximately 25% of admissions are unnecessary-and many of those unnecessary ones are among white patients.

What might be creating such lopsidedness? Dr. Chamberlain offered conjecture that anxiety may, at least in part, be to blame-although not on the patients' part: namely, "rich, anxious parents" and, even more likely, "over-anxious physicians" who, at some level, felt a need to fill beds in suburban hospitals. Compounding this overrepresentation, Dr. Chamberlain reminded the audience, is the fact that "hospitals are a virtual cesspool of contagion" and admitted patients are often back within a few weeks with an infection acquired during the hospital stay.

"More," Dr. Chamberlain concluded, "is not always better." (Platform Session 5145)