Hospital Care Varies Greatly for Children with Urinary Tract Infections
Posted on: Tuesday, 21 April 2009, 11:15 CDT
-Standardizing Care May Improve Quality, Reduce Hospital Stays-
The findings of the study provide an opportunity to eliminate potential waste in the healthcare system and to engage in quality improvement efforts for this common condition, according to study co-authors
"The variability across hospitals represents an opportunity for benchmarking and standardization of care," says Dr. Conway. "Decreased length of stay and costs associated with clinical practice guidelines support their implementation."
The study is the first large-scale investigation of variability in urinary tract infection (UTI) management and was published online
"It's astonishing that in this day and age children with the same common condition - urinary tract infections - are being managed so differently from one hospital to the next," says Dr. Keren, the director of the Center for Pediatric Clinical Effectiveness at The Children's Hospital of
Drs. Conway and Keren studied 20,892 children between the ages of 1 month and 12 years old hospitalized at one of 25 children's hospitals between 1999 and 2004. They found significant variability among hospitals in terms of length of stay, costs, readmission rates and test performed.
They also found that certain patient and hospital factors explained some of these differences. For example, older children had shorter length of stay and lower costs, and were less likely to undergo imaging and to be admitted to the intensive care unit. On the other hand, African-American and Latino patients had longer length of stay and higher costs, and were more likely to undergo imaging and to be admitted to the intensive care unit. Perhaps most importantly, length of stay and costs were lower at hospitals that used clinical practice guidelines for the management of UTI.
"Patients should not receive different care based on where they live and the hospital they go to," says Dr. Conway. "Clinical practice guidelines, such as those adopted by Cincinnati Children's, have been shown to decrease variability of care, length of stay and costs. The healthcare system in
Dr. Conway received a training grant from the Robert Wood Johnson Clinical Scholars Program at the
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Cincinnati Children's Hospital Medical Center is one of America's top three children's hospitals for general pediatrics and is highly ranked for its expertise in digestive diseases, respiratory diseases, cancer, neonatal care, heart care and neurosurgery, according to the annual ranking of best children's hospitals by U.S. News & World Report. One of the three largest children's hospitals in the U.S., Cincinnati Children's is affiliated with the
For its achievements in transforming healthcare, Cincinnati Children's is one of six U.S. hospitals since 2002 to be awarded the American Hospital Association-McKesson Quest for Quality Prize for leadership and innovation in quality, safety and commitment to patient care. The hospital is a national and international referral center for complex cases, so that children with the most difficult-to-treat diseases and conditions receive the most advanced care leading to better outcomes. Additional information can be found at www.cincinnatichildrens.org.
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