These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: Patient volume and quality of care for young children hospitalized with acute gastroenteritis.
    Author: McLeod L, French B, Dai D, Localio R, Keren R.
    Journal: Arch Pediatr Adolesc Med; 2011 Sep; 165(9):857-63. PubMed ID: 21893651.
    Abstract:
    OBJECTIVE: To explore the relationship between the volume of children admitted to the hospital with acute gastroenteritis and adherence to recommended quality indicators. DESIGN: Retrospective cohort study. SETTING: Premier Perspective clinical and financial information systems database (Premier Inc, Charlotte, North Carolina). PARTICIPANTS: A total of 12,604 otherwise healthy children aged 3 months to 10 years hospitalized between January 1, 2007, and December 31, 2009, at 280 US hospitals with International Classification of Diseases, Ninth Revision diagnosis codes indicating acute gastroenteritis. MAIN EXPOSURE: Volume of hospital admissions per year of children with acute gastroenteritis. MAIN OUTCOME MEASURES: Quality indicators for overuse and misuse of care in the management of acute gastroenteritis based on nationally published guidelines. These include blood testing, stool studies, use of antibiotics, and use of nonrecommended antiemetic or antidiarrheal medications (hereafter referred to as nonrecommended medications). RESULTS: Selected blood, stool, and rotavirus tests (overuse indicators) were performed in 85%, 46%, and 56% of children, respectively. Six percent of children received nonrecommended medications, and 26% received antibiotics (misuse indicators). Higher volumes of hospital admission for acute gastroenteritis were associated with less use of blood tests (odds ratio [OR], 0.67 [95% confidence interval {CI}, 0.50-0.89]), nonrecommended medications (OR, 0.84 [95% CI, 0.76-0.93]), and antibiotics (OR, 0.93 [95% CI, 0.86-0.99]). Children admitted to hospitals in the 25th vs 75th percentile of patient volume had a 10%, 30%, and 10% increased chance of having blood tests, nonrecommended medications, and antibiotics ordered, respectively. CONCLUSIONS: In a nationally representative sample of hospitals that care for children with acute gastroenteritis, higher patient volumes were associated with greater adherence to established quality indicators. Further investigation is needed to identify the hospital characteristics driving the volume-quality relationship for this common pediatric condition.
    [Abstract] [Full Text] [Related] [New Search]