Trends in Observation‐prone Emergency Department Visits Among Michigan Children, 2007–2011

Abstract

Objectives: To the best of the authors' knowledge, admission of children under observation status in community hospitals has not been examined. The hypothesis of this study was that there has been an increase in observation charge code use over time and variations in the application of observation charge codes across hospital types.Methods: This was a cross-sectional analysis of 5 years (2007 through 2011) of administrative claims data from Michigan residents enrolled in Medicaid, Blue Cross/Blue Shield of Michigan preferred provider organization, and Blue Cross Network health maintenance organization compiled into a single data set. Emergency department (ED) visits to facilities in Michigan made by children (younger than 18 years) were selected. Observation-prone ED visits were identified based on the presence of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. Counts of observationprone ED visits were determined and descriptive statistics were calculated. Changes over time in the proportion of visits with observation charge codes by hospital type were assessed with chi-square analysis.