Variation in inpatient resource utilization and management of apparent life-threatening events

The Journal of Pediatrics
Joel S TiederDimitri A Christakis

Abstract

To report national variations in diagnostic approaches to apparent life-threatening events (ALTEs) and resource utilization. Using the Pediatric Health Information System, we studied children who were age 3 days to 5 months at admission and were discharged with an International Classification of Diseases, Ninth Revision (ICD-9) code potentially identifiable as ALTE. Multiple analysis of variance was used to determine whether the variances in adjusted charges, length of stay (LOS), and diagnostic studies were hospital-related after controlling for other covariates. Logistic regression was used to study the association of readmission rates with discharge diagnosis and specific diagnostic studies. The study group comprised 12,067 patients, with a mean LOS of 4.4 days (standard deviation +/- 5.6 days) and mean adjusted charges of $15,567 ($28,510) per admission. The mean in-hospital mortality rate was 0.56% (n = 68), and the rate of 30-day readmission was 2.5%. The most common discharge diagnoses were gastroesophageal reflux 36.9% (48.3%) and lower respiratory tract infection 30.8% (46.2%). Mean LOS, total adjusted charges, and use of diagnostic studies varied considerably across hospitals, and hospital-level differences were a sig...Continue Reading

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Citations

Mar 14, 2012·Pediatrics·Michael R StengerWilliam Gardner
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Feb 19, 2013·The Journal of Pediatrics·Joel S TiederMichael B H Smith
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