Gender differences in children's hospitalization in Catalonia: another inequality?

The aim of this study was to describe children's hospitalization and to ana lyse gender differences by selected diagnostic and procedure groups. Using the Clinical Classification for Health Policy Research Version 2 (CCHPR), 8 1888 hospitalizations from the Minimum Basic Data Set of Hospital Discharge (CMBDAH) of 1995 related to children under 15 y of age in Catalonia, Spain , were studied. Hospitalization rates, number of days in hospital, average length of stay (d) in hospital and the standardized hospitalization ratio ( SHR) (hospitalization rate in boys/hospitalization rate in girls) were comp uted. Two independent approaches were taken: (i) gender-specific categories were excluded in order to compare hospitalizations by sex; (ii) a selected group of 17 diagnostic and procedure categories were chosen in order to ca rry out the specific gender comparison. In both approaches, the selected in dicators were compared by age groups, and totals were standardized by age u sing the direct method. An excess of hospitalization in boys was observed ( SHR = 1.18; 95% CI: 1.17-1.19). The number of days spent in hospital and ho spitalization rates were higher in infants and were also higher for boys th an for girls. The average length of stay in hospital was higher in infants and in girls at all ages. These differences were systematic when stratified by health region, admission and discharge circumstances and hospital categ ory. Except for urinary infection, which was higher in girls (SHR: 0.65; CI 95%: 0.54-0.76), the SHR was higher in bays in all diagnostic and procedur e categories analysed tall SHR > 1). Specific sex categories, injuries and poisonings cannot on their own explain a higher level of hospitalization am ong boys. More specific studies are needed to explain the role of the famil y and the healthcare system in gender inequalities in children's hospitaliz ation.