Abstract:
OBJECTIVE:Bronchiolitis is a major cause of infant morbidity and contributes to millions of dollars in health care costs. Care guidelines may cut costs by reducing unnecessary resource utilization. Through the implementation of a guideline, we sought to reduce unnecessary resource utilization and improve the value of care provided to infants with bronchiolitis in a pediatric emergency department (ED). METHODS:We conducted an interrupted time series that examined ED visits of 2929 patients with bronchiolitis, aged 1 to 12 months old, seen between November 2007 and April 2013. Outcomes were proportion having a chest radiograph (CXR), respiratory syncytial virus (RSV) testing, albuterol or antibiotic administration, and the total cost of care. Balancing measures included admission rate, returns to the ED resulting in admission within 72 hours of discharge, and ED length of stay (LOS). RESULTS:There were no significant preexisting trends in the outcomes. After guideline implementation, there was an absolute reduction of 23% in CXR (95% confidence interval [CI]: 11% to 34%), 11% in RSV testing (95% CI: 6% to 17%), 7% in albuterol use (95% CI: 0.2% to 13%), and 41 minutes in ED LOS (95% CI: 16 to 65 minutes). Mean cost per patient was reduced by $197 (95% CI: $136 to $259). Total cost savings was $196,409 (95% CI: $135,592 to $258,223) over the 2 bronchiolitis seasons after guideline implementation. There were no significant differences in antibiotic use, admission rates, or returns resulting in admission within 72 hours of discharge. CONCLUSIONS:A bronchiolitis guideline was associated with reductions in CXR, RSV testing, albuterol use, ED LOS, and total costs in a pediatric ED.
journal_name
Pediatricsjournal_title
Pediatricsauthors
Akenroye AT,Baskin MN,Samnaliev M,Stack AMdoi
10.1542/peds.2013-1991subject
Has Abstractpub_date
2014-01-01 00:00:00pages
e227-34issue
1eissn
0031-4005issn
1098-4275pii
peds.2013-1991journal_volume
133pub_type
杂志文章相关文献
PEDIATRICS文献大全abstract::A large neuroblastoma screening study was recently started in the province of Quebec, Canada. This project, a collaboration between the Quebec Network for Genetic Medicine and the University of Minnesota, is studying the impact of screening infants for the preclinical detection of neuroblastoma on the population-based...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1990-11-01 00:00:00
abstract::During a 12-month period 80 children greater than 3 months of age seen at an emergency room with acute fevers greater than or equal to 39.7 C (103.5 F) and no localizing signs of infection were studied using blood and buffy coat cultures to isolate bacteria and viruses. Bacteremia was identified in three children (3.8...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1981-08-01 00:00:00
abstract:OBJECTIVES:To determine whether infants who are fed initially and advanced at 30 mL/kg per day (intervention) take fewer days to get to full feedings than those who are fed initially and advanced at 20 mL/kg per day (control), without increasing their incidence of feeding complications and necrotizing enterocolitis (NE...
journal_title:Pediatrics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1542/peds.2004-1232
更新日期:2004-12-01 00:00:00
abstract:OBJECTIVE:Incorporating Healthy Steps for Young Children into pediatric practice has been shown to have positive effects for children and families. Although this model of care has also been integrated into several pediatric and family medicine training programs, published reports to date have focused only on residents'...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2005-3090
更新日期:2007-09-01 00:00:00
abstract::The publication of guidelines calling for less aggressive treatment of jaundice in newborns has been followed by a reappearance of case reports of kernicterus. These case reports illustrate important issues for writers and consumers of practice guidelines. One issue is the particular salience of identified patients wi...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:2000-01-01 00:00:00
abstract:OBJECTIVE:Numerous nutrition policy statements recommend the consumption of 800 to 1500 mg of calcium largely from dairy products for osteoporosis prevention; however, the findings of epidemiologic and prospective studies have raised questions about the efficacy of the use of dairy products for the promotion of bone he...
journal_title:Pediatrics
pub_type: 杂志文章,评审
doi:10.1542/peds.2004-0548
更新日期:2005-03-01 00:00:00
abstract:BACKGROUND:The Reach Out and Read (ROR) program promotes early literacy as part of pediatric primary care through the distribution of children's books and anticipatory guidance during early childhood. OBJECTIVES:To improve the rates of age-appropriate book-giving during well-child care and the delivery of ROR-recommen...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2010-2290
更新日期:2011-04-01 00:00:00
abstract::This article reviews current evidence for autism spectrum disorder (ASD) interventions for children aged <3 years, based on peer-reviewed articles published up to December 2013. Several groups have adapted treatments initially designed for older, preschool-aged children with ASD, integrating best practice in behaviora...
journal_title:Pediatrics
pub_type: 共识发展会议,杂志文章,实务指引
doi:10.1542/peds.2014-3667E
更新日期:2015-10-01 00:00:00
abstract::A caregiver may fail to recognize or respond to a child's medical needs for a variety of reasons. An effective response by a health care professional to medical neglect requires a comprehensive assessment of the child's needs, the parents' resources, the parents' efforts to provide for the needs of the child, and opti...
journal_title:Pediatrics
pub_type: 杂志文章,评审
doi:10.1542/peds.2007-2903
更新日期:2007-12-01 00:00:00
abstract::This publication contains the pediatric and neonatal sections of the 2005 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations (COSTR). The consensus process that produced this document was sponsored by the International Liaison Committee on ...
journal_title:Pediatrics
pub_type: 杂志文章,实务指引
doi:10.1542/peds.2006-0206
更新日期:2006-05-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Although opioid pain relievers are commonly prescribed in pregnancy, their association with neonatal outcomes is poorly described. Our objectives were to identify neonatal complications associated with antenatal opioid pain reliever exposure and to establish predictors of neonatal abstinence s...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2014-3299
更新日期:2015-05-01 00:00:00
abstract::The frequency and severity of 17 side effects presumably associated with stimulant medication were assessed during a rigorous, triple-blind, placebo-controlled, crossover evaluation of methylphenidate, 0.3 and 0.5 mg/kg twice a day, in 83 children with attention deficit hyperactivity disorder. Side effects were rated ...
journal_title:Pediatrics
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1990-08-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Primary disabilities in children prenatally exposed to alcohol have a major impact on their daily life. It is suggested that these issues persist into adulthood, but few studies have addressed the outcome in adults with prenatal exposure, especially those with fetal alcohol syndrome (FAS). The ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2014-1915
更新日期:2015-01-01 00:00:00
abstract:OBJECTIVES:The objectives of this study were to examine the impact of postpartum hospital-stay legislation on newborns' length of stay, neonatal readmissions, and 1-year mortality in California, and whether this legislation had differential impacts by demographics and complications during delivery or pregnancy. METHOD...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2005-3044
更新日期:2006-07-01 00:00:00
abstract:OBJECTIVES:To compare measures of psychometric assessment and school difficulties in a cohort of extremely low birth weight (ELBW) teenagers and term controls, and to determine whether there is stability in psychometric measures between age 8 and the teen years. STUDY DESIGN:Longitudinal follow-up; geographically defi...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.105.2.325
更新日期:2000-02-01 00:00:00
abstract:OBJECTIVES:Contrary to the importance of total sleep duration, the association between sleeping through the night and development in early infancy remains unclear. Our aims were to investigate the proportion of infants who sleep through the night (6- or 8-hour sleep blocks) at ages 6 and 12 months in a longitudinal coh...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2017-4330
更新日期:2018-12-01 00:00:00
abstract::Osteogenesis imperfecta may be difficult to differentiate from nonaccidental trauma. Social history may prejudice the physician in favor of or against considering the diagnosis of child abuse. Three cases of osteogenesis imperfecta that were initially diagnosed as nonaccidental trauma are presented. The availability o...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1991-11-01 00:00:00
abstract:OBJECTIVES:To examine associations of the timing of complementary feeding (CF) introduction with adiposity throughout childhood. METHODS:We studied 1013 children from Project Viva. Our exposure was CF introduction, categorized as <4 months (19%), 4 to <6 months (68%; reference group), and ≥6 months of age (14%). Our o...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2019-1320
更新日期:2019-12-01 00:00:00
abstract::An outbreak of Mycoplasma pneumoniae infection occurred in the summer of 1978 in a boys' camp in northern Wisconsin and affected 139 of 196 persons (71%); 115 (59%) had laboratory evidence of infection. In 77% of the cases, onset of disease occurred within three weeks after arrival at camp, in contrast to the usually ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1980-12-01 00:00:00
abstract:OBJECTIVES:Puberty suppression (PS) is a cornerstone of treatment in youth experiencing gender dysphoria. In this study, we aim to inform prescribing professionals on the long-term effects of PS treatment on the development of sex characteristics and surgical implications. METHODS:Participants received PS according to...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2019-3653
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Much effort has been directed toward increasing the training of physicians from underrepresented minority groups, yet few direct comparisons have examined the diversity of the racial/ethnic backgrounds of the physicians relative to the patient populations they serve, either currently or into the future. This...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.105.1.27
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:It remains unclear if fatal brain injuries in young children are characterized by immediate rapid deterioration or can present after an initial period of lucidity. This issue has legal implications in child abuse, for which understanding the clinical course affects perpetrator identification. OBJECTIVE:To d...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2004-2671
更新日期:2005-07-01 00:00:00
abstract:BACKGROUND:The "Guide to Community Preventive Services" strongly recommends reducing out-of-pocket costs to increase vaccination rates among children. Nevertheless, out-of-pocket expenses are still incurred during the receipt of childhood vaccines, vaccine administration, and associated well-child visits. OBJECTIVE:Ou...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2006-3654
更新日期:2007-11-01 00:00:00
abstract:OBJECTIVE:We describe patient characteristics and postoperative morbidity and mortality rates for patients with Down syndrome undergoing congenital heart disease surgery. METHODS:This retrospective cohort study used the Society of Thoracic Surgeons Congenital Heart Surgery Database to compare patient characteristics a...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2009-3245
更新日期:2010-08-01 00:00:00
abstract::On the rare occasion when neonatal goiter is the cause of airway compromise, it typically presents with a palpable neck mass. In the setting of maternal Graves' disease (GD), fetal and neonatal goiters are most commonly caused by maternal treatment with antithyroid medication, and the goiter resolves within days of in...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2012-3000
更新日期:2013-10-01 00:00:00
abstract::A measles outbreak in an inner-city area primarily involved preschool-aged children younger than 5 years of age. The reasons why 31 unvaccinated preschool children with measles disease had not been vaccinated were investigated. For some patients, health care providers missed opportunities to vaccinate eligible patient...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1989-03-01 00:00:00
abstract:OBJECTIVES:Although safe and effective vaccines are available to protect against tetanus in the United States and vaccination rates are high, cases of tetanus among children continue to occur. The objectives of this article are to describe reported cases of tetanus in children in the United States and to identify the r...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.109.1.e2
更新日期:2002-01-01 00:00:00
abstract:CONTEXT:Research reveals racial, ethnic, and socioeconomic disparities in autism diagnosis; there is limited information on potential disparities related to other dimensions of services. OBJECTIVE:We reviewed evidence related to disparities in service use, intervention effectiveness, and quality of care provided to ch...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2019-1895G
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVE:The goal of this study was to evaluate the impact of the Active Teen Leaders Avoiding Screen-time (ATLAS) intervention for adolescent boys, an obesity prevention intervention using smartphone technology. METHODS:ATLAS was a cluster randomized controlled trial conducted in 14 secondary schools in low-income c...
journal_title:Pediatrics
pub_type: 杂志文章,随机对照试验
doi:10.1542/peds.2014-1012
更新日期:2014-09-01 00:00:00
abstract::Schools are in a uniquely favorable position to increase physical activity and fitness among their students. This policy statement reaffirms the American Academy of Pediatrics' support for the efforts of schools to include increased physical activity in the curriculum, suggests ways in which schools can meet their goa...
journal_title:Pediatrics
pub_type: 指南,杂志文章,实务指引
doi:10.1542/peds.105.5.1156
更新日期:2000-05-01 00:00:00