Pediatric hospital admissions for measles lessons from the 1990 epidemic

To examine the descriptive epidemiology of serious measles complications and associated hospital costs during a major epidemic, we used California population-based hospital discharge data to identify hospital admissions for measles during 1986 through 1990 (ICD-9 code 055, n = 4,201). We examined 5-year trends and, for 1990 pediatric epidemic cases (n = 2,234), sociodemographic and hospital admission financial data. Hospital admission rates for measles rose significantly between 1986 and 1990. During the 1990 epidemic, preschool children aged 1 to 5 years, Medi-Cal (California's Medicaid) beneficiaries, Hispanics, and those living in urban counties accounted for most hospital admissions. Young infants and residents of southern California and the San Joaquin Valley had the highest risks. Medi-Cal beneficiaries and Asian children were at an increased risk for death during the hospital stay, The average hospital admission cost was $8,201, and the average length of hospital stay was 4.6 days. Hospital costs amounted to $18 million, two thirds of which was paid for by Medi-Cal. Measles is a serious disease that can result in severe complications requiring lengthy and costly hospital stays. We must remain alert to its continuing threat, complications, and resulting financial burdens.