This document presents a statistical study of hospital use by children in the United States and Canada designed to determine why the hospital discharge rate of children in the United States is lower than many other Western industrialized nations, although the discharge rate for the general U.S. population is higher. Several reasons for the lower rate are suggested, including the possibilities that American children are in better health, fewer children are hospitalized unnecessarily in the United States, or some children are not receiving needed hospital care. A comparison of Canadian and U.S. statistics is included because of the two countries' similar hospital structure and data. Data are presented in three areas. Hospital use is compared using data on age and sex, diagnosis, surgical procedures, newborn infants, and hospital fatalities. Health status is compared using morbidity, mortality, and cause of death data. Health services are compared using supply and distribution of resources, physician utilization, and health insurance data. It is concluded that: (1) children in the United States had lower discharge rates for upper respiratory infections but higher infant mortality; (2) ambulatory care appeared to be used more in the United States than in Canada; and (3) more U.S. children were uninsured than were Canadian children. A 1983 statistical update is included. (ABL)