Institutional variation in ordering complete blood counts for children hospitalized with bronchiolitis This work was presented at the Pediatric Academic Society Meeting, May 2005.
|dc.contributor.author||Tarini, Beth A.||en_US|
|dc.contributor.author||Garrison, Michelle M.||en_US|
|dc.contributor.author||Christakis, Dimitri A.||en_US|
|dc.identifier.citation||Tarini, Beth A.; Garrison, Michelle M.; Christakis, Dimitri A. (2007)."Institutional variation in ordering complete blood counts for children hospitalized with bronchiolitis This work was presented at the Pediatric Academic Society Meeting, May 2005. ." Journal of Hospital Medicine 2(2): 69-73. <http://hdl.handle.net/2027.42/56033>||en_US|
|dc.description.abstract||BACKGROUND In the evaluation of infants with bronchiolitis there is little evidence to support the use of diagnostic testing, particularly complete blood counts (CBCs). However, the extent to which CBCs are ordered in the evaluation of infants with bronchiolitis is unknown. OBJECTIVES (1) To determine institutional variability in ordering of initial and repeat CBCs in infants hospitalized with bronchiolitis; (2) to examine the relationship between proportion of admissions with CBCs and mean hospital charges. METHODS We analyzed the Pediatric Health Information System database, which contains demographic and diagnostic data from 30 U.S. children's hospitals. We restricted our analysis to children less than 12 months old with a primary discharge diagnosis of bronchiolitis and an APR-DRG of bronchiolitis/asthma. We performed multivariate ANOVA to examine variability in initial and repeat CBC ordering across hospitals, controlling for potential confounders. We used stratified logistic regression to determine which factors were associated with repeat CBCs. We examined the relationship between proportion of admissions with CBCs and mean hospital charges using t tests. RESULTS 17,397 children were included in the analysis, and 48.2% had at least 1 CBC, whereas 7.8% had more than 1 CBC. The proportion of admissions with initial (23.2%-70.2%) and repeat (0%-18.6%) CBCs varied significantly across hospitals. Compared to those hospitals with the lowest proportion of admissions with CBCs, hospitals with higher proportions of CBCs had significantly higher mean hospital stay charges. CONCLUSIONS Given the potential downstream medical and financial consequences associated with CBC ordering in evaluation of infants with bronchiolitis, explanations for institutional variation warrant exploration. Journal of Hospital Medicine 2007;2:69–73. © 2007 Society of Hospital Medicine.||en_US|
|dc.publisher||Wiley Subscription Services, Inc., A Wiley Company||en_US|
|dc.subject.other||Life and Medical Sciences||en_US|
|dc.title||Institutional variation in ordering complete blood counts for children hospitalized with bronchiolitis This work was presented at the Pediatric Academic Society Meeting, May 2005.||en_US|
|dc.contributor.affiliationum||Division of General Pediatrics, University of Michigan, Ann Arbor, Michigan ; Child Health Evaluation and Research Unit, University of Michigan, Ann Arbor, Michigan ; Dr. Tarini had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. ; Division of General Pediatrics, University of Michigan, 300 N. Ingalls St., Room 6C11, Ann Arbor, MI 48109-0456||en_US|
|dc.contributor.affiliationother||Child Health Institute, University of Washington, Seattle, Washington||en_US|
|dc.contributor.affiliationother||Child Health Institute, University of Washington, Seattle, Washington ; Children's Hospital and Regional Medical Center, Seattle, Washington||en_US|
|dc.identifier.source||Journal of Hospital Medicine||en_US|
|dc.owningcollname||Interdisciplinary and Peer-Reviewed|
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