Many pediatric respiratory hospitalizations unnecessary

Sep 11 2012

By Helen Albert, Senior medwireNews Reporter

Study findings suggest that a large number of pediatric hospitalizations, particularly those of a respiratory nature, could be prevented.

The researchers believe that substantial healthcare savings could be made by caring for children with ambulatory care-sensitive (ACS) conditions who do not require hospitalization in the primary care setting.

Sam Lu and Dennis Kuo, from the University of Arkansas in Little Rock, USA, analyzed data from the 2006 Kids' Inpatient Database (n=7,558,812) in the USA to assess the proportion of children aged 0 to 17 years hospitalized with 16 ACS conditions over the year and calculate associated costs.

The ACS conditions included asthma, bacterial pneumonia, cellulitis, dental conditions, failure to thrive, gastroenteritis, convulsions, anemia, nutritional deficiencies, diabetes, pelvic inflammatory disease, and serious ear, nose, and throat infections, among others.

"Although not all admissions for these conditions are avoidable," explain Lu and Kuo, "timely ambulatory care could temper the disease course and thus prevent progression to where hospitalization is medically indicated."

Hospitalizations for the 16 ACS conditions included in the study accounted for 1,087,570 hospitalization days in 2006 and cost US$ 4.05 (€ 3.16) billion in total.

A large percentage of ACS hospitalization days (48.4%) and hospital charges (46.7%) could be accounted for by hospitalizations for asthma and bacterial pneumonia. Potentially preventable pediatric hospitalizations for ACS respiratory conditions in general accounted for US$ 1.96 (€ 1.53) billion in 2006.

When the researchers carried out further analysis adjusting for potential confounders, they found that factors significantly associated with admission to hospital with an ACS condition included being male, non-White, and being admitted though the emergency department.

"Respiratory conditions are responsible for almost one-half of potentially preventable pediatric hospitalizations," write the authors in Academic Pediatrics.

"Future research to prevent pediatric hospitalizations should examine targeted interventions in the primary care setting, specifically around respiratory conditions and minority populations," they conclude.

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