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Children's Hospitals Vary in Admission Rates

TUESDAY, Aug. 12, 2014 (HealthDay News) -- U.S. children's hospitals show three-fold variation in admission rates for common pediatric conditions, even when adjusting for severity of illness, according to a study published online Aug. 11 in Pediatrics.

Florence T. Bourgeois, M.D., from Boston Children's Hospital, and colleagues analyzed data from children presenting to the emergency departments of 35 pediatric tertiary-care hospitals participating in the Pediatric Health Information System (visits occurring between Jan. 1, 2009, and Dec. 31, 2012). Rates were calculated for seven common conditions and corrected to adjust for hospital-level severity of illness.

The researchers found that 13.8 percent of all emergency department encounters (1,288,706) were associated with one of the seven conditions of interest. The greatest variation in admission rates was observed for concussion (range, 5 to 72 percent), followed by pneumonia (19 to 69 percent) and bronchiolitis (19 to 65 percent), after adjusting for hospital-level severity. Patients presenting with seizures (7 to 37 percent) and kidney and urinary tract infections (6 to 37 percent) showed the least variation in admission rates. Certain hospitals had consistently higher and lower admission rates.

"Although local practices and hospital-level factors may partly explain this variation, our findings highlight the need for greater focus on the standardization of decisions regarding admission," the authors write.

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