ArticlePediatrics2014
Variation in emergency department admission rates in US children's hospitals.
Article in Pediatrics, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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Who cites it
25 citing papers in PubMed.
- Prognostic clinical decision support for pneumonia in the emergency department: A randomized trial.Journal of hospital medicine · 2024Trial
- Pediatric Emergency Care Variation: Might Normothetic Data Undermine Adaptive Expertise?Perspectives on medical education · 2026Article
- Differences in Admission Rates of Children with Pneumonia Between Pediatric and Community Emergency Departments.The western journal of emergency medicine · 2025Article
- Validation of Childhood Pneumonia Prognostic Models for Use in Emergency Care Settings.Journal of the Pediatric Infectious Diseases Society · 2023Article
- Intravenous Magnesium: Prompt Use for Asthma in Children Treated in the Emergency Department (IMPACT-ED): Protocol for a Multicenter Pilot Randomized Controlled Trial.JMIR research protocols · 2023Article
- Red Blood Cell Distribution Width and Pediatric Community-Acquired Pneumonia Disease Severity.Hospital pediatrics · 2022Article
- Facilitating Health Information Exchange to Improve Health Outcomes for School-Aged Children: School Nurse Electronic Health Record Access.Applied clinical informatics · 2022Article
- Paediatric emergency care at an academic referral hospital in Mozambique.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2021Article
- Racial and ethnic disparities in bronchiolitis management in freestanding children's hospitals.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2021Article
- Pneumonia Severity in Children: Utility of Procalcitonin in Risk Stratification.Hospital pediatrics · 2021Article
- Pilot Study of Peak Plasma Concentration After High-Dose Oral Montelukast in Children With Acute Asthma Exacerbations.Journal of clinical pharmacology · 2021Observational
- Care of Children with Supraventricular Tachycardia in the Emergency Department.Pediatric cardiology · 2021Article
- Observational
- Paediatric dermatological conditions in an emergency department: a single-centre study in Thailand.BMJ paediatrics open · 2021Article
- Article
- Discharge Home After Transition to Oral Antibiotics: No Jeopardy.Hospital pediatrics · 2020Article
- Management of children visiting the emergency department during out-of-office hours: an observational study.BMJ paediatrics open · 2020Article
- A Respiratory Therapist-Driven Asthma Pathway Reduced Hospital Length of Stay in the Pediatric Intensive Care Unit.Respiratory care · 2019Article
- Mortality Predictive Scores for Community-Acquired Pneumonia in Children.Current infectious disease reports · 2019Review
- Machine Learning-Based Prediction of Clinical Outcomes for Children During Emergency Department Triage.JAMA network open · 2019Article
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Authors and funding
4 authors.
Funding
Abstract
objectiveTo measure the hospital-level variation in admission rates for children receiving treatment of common pediatric illnesses across emergency departments (EDs) in US children's hospitals.
methodsWe performed a multi-center cross sectional study of children presenting to the EDs of 35 pediatric tertiary-care hospitals participating in the Pediatric Health Information System (PHIS). Admission rates were calculated for visits occurring between January 1, 2009, and December 31, 2012, associated with 1 of 7 common conditions, and corrected to adjust for hospital-level severity of illness. Conditions were selected systematically based on frequency of visits and admission rates.
resultsA total of 1288706 ED encounters (13.8% of all encounters) were associated with 1 of the 7 conditions of interest. After adjusting for hospital-level severity, the greatest variation in admission rates was observed for concussion (range 5%-72%), followed by pneumonia (19%-69%), and bronchiolitis (19%-65%). The least variation was found among patients presenting with seizures (7%-37%) and kidney and urinary tract infections (6%-37%). Although variability existed in disease-specific admission rates, certain hospitals had consistently higher, and others consistently lower, admission rates.
conclusionsWe observed greater than threefold variation in severity-adjusted admission rates for common pediatric conditions across US children's hospitals. 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.
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