Original ArticleVariation in the Management of Infants Hospitalized for Bronchiolitis Persists after the 2006 American Academy of Pediatrics Bronchiolitis Guidelines
Section snippets
Methods
This multicenter cross-sectional study included inpatient visits of children diagnosed with bronchiolitis. Data were from the PHIS, an administrative database of 43 not-for-profit, tertiary care pediatric hospitals in the US affiliated with the Children's Hospital Association, Shawnee Mission, Kansas. This database accounts for ∼20% of annual pediatric hospitalizations in the US. Data quality and reliability are assured through a joint effort between Children's Hospital Association and
Results
In total, 64 994 inpatient hospitalizations for bronchiolitis from October 2007 through March 2012 were eligible for inclusion and analyzed across the 42 PHIS hospitals (Table I; available at www.jpeds.com). The mean age of the cohort was 3.7 months (SD, 3.2 months). There was a male predominance (57.7%), and government payers insured most study subjects (51.4%). Most patients were classified as having illness of minor (56.6%) or moderate (36.6%) severity and most visits occurred in the winter
Discussion
This multicenter study of children hospitalized for bronchiolitis in 42 pediatric hospitals after the publication of the AAP bronchiolitis guidelines demonstrates significant and substantial variation in 5 resources not routinely recommended by the guideline. A key strength of our study is the examination of resource use and the outcomes of LOS and readmission. Utilization of all 5 resources was associated with increased LOS. We found that resource use was not associated with decreased odds for
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The authors declare no conflicts of interest.
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Current affiliation is Seattle Children's Hospital, Seattle, WA.