Length of paediatric inpatient stay, socio-economic status and hospital configuration: a retrospective cohort study

Heys, Michelle; Rajan, Matthew; Blair, Mitch

doi:10.1186/s12913-017-2171-x

Cited by 15 publications

(18 citation statements)

References 14 publications

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“…Further research should ascertain the impact of unmeasured factors, outside of patient illness severity, on the hospital LOS, given the potential for multiple patient characteristics, practice patterns, or institutional factors to cause wide differences in LOS across hospitals. 29,30 Similar to the current study, prior studies of hospitalizations for common pediatric conditions, 31,32 including sepsis, 11 have reported significant differences in charges by hospital type. It could be surmised that more subspecialty care and higher use of advanced technology within urban hospitals might explain some of the differentially higher charges reported for urban versus rural hospitals in the current study, likely reflecting higher patient illness severity and medical complexity.…”

Section: Discussionsupporting

confidence: 77%

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Resource Use and Outcomes for Children Hospitalized With Severe Sepsis or Septic Shock

Odetola

2019

J Intensive Care Med

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Objective: To describe patient and hospital characteristics associated with in-hospital mortality, length of stay (LOS), and charges for children with severe sepsis or septic shock who often require specialized organ-supportive technology to enhance outcomes, availability of which might vary across hospitals. Design: Retrospective study among children hospitalized for severe sepsis or septic shock, using the 2012 Kids’ Inpatient Database. Multivariate regression methods identified factors associated with mortality, LOS, and charges. Measurements and Main Results: Of an estimated 11 972 hospitalizations for pediatric severe sepsis or septic shock, most hospitalizations (85%) were to urban teaching hospitals. Hospitalizations were more frequent among neonates and older adolescents than other age groups. Mortality was 17%, average LOS was 24 days, and average hospital charges were US$314 950. Higher mortality was associated with neonates, cumulative organ dysfunction, more comorbidities, and cardiopulmonary resuscitation. Longer hospitalization and higher charges were associated with neonates, more comorbidities, higher illness severity, invasive medical technology, and urban hospitals. Conclusions: Efforts to mitigate the substantial in-hospital mortality and resource use observed in pediatric severe sepsis or septic shock should be age-specific and focused on the influence of comorbidities and organ dysfunction on outcomes. Future research should elucidate reasons for higher resource use at urban hospitals.

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Resource Use and Outcomes for Children Hospitalized With Severe Sepsis or Septic Shock

Odetola

2019

J Intensive Care Med

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“…4 Emergency admission rates and short stay admissions for minor diseases in children throughout the UK are on the rise. 5 The mean hospital length in the UK has dropped from 3.9 to 1.9 days in comparison over the past 30 years. 6 There is a significant variation in the mean LOS for children and young people across the United Kingdom in 2009 reported between 0, 1 and 4, 4 days.…”

Section: Introductionmentioning

confidence: 99%

Seasonal variations among admitted paediatric patients at tertiary care hospital, Gadap Town, Karachi, Pakistan

Seema¹,

Khan²,

Jiskani³

et al. 2019

Int J Res Med Sci

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Background: In pediatrics, the season is one of the elements contributing to the etiological factors of community based diseases. Awareness of this variation can help the physicians for prevention and counseling of the patients. A cross-sectional observational study was designed with non-probability convenient sampling technique to determine the frequency of patients admitted to the paediatric ward of the hospital in a whole calendar year and to ascertain which disease presentation is most common. Methods: Study conducted at paediatric ward of Al-Tibri Medical College and Hospital Karachi, Pakistan having patients admitted during May 2018 to April 2019. After ethical approval and informed consent from their parents/ guardian, a total of 734 paediatric patients that were admitted from paediatric OPD/ emergency were selected for the study. Paediatric patients that were referred, in emergency/ ICU and surgical paediatric patients were excluded from the study. Chi-square test was applied to evaluate the statistical variation among the patients.Results: From the 734 patients, 357 (48.6%) patients were of acute gastroenteritis, 104 (14.2%) of respiratory illness, 86 (11.7%) of viral fever, 67 (9.1%) of urinary tract infection, 36 (4.9%) of neurological illness, 29 (4.0%) of protein calorie malnutrition, 25 (3.4%) of enteric fever, 20 (2.7%) of haematological illness and 10 (1.4%) patients were admitted due to sepsis.Conclusion: Our study concluded that majority of the patients admitted were of acute gastroenteritis / admitted due to gastric issues, therefore further studies in the vicinity would help to better understand the issues and help plan a strategy to combat the diseases.

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“…20,21 Duration of hospital stay (6.17 ± 2.01 days) was found similar to study conducted by Choudhary et al (6.05 ± 3.45 days) and more than the study done by Heys et al (1.8 days). 13,22 Though, antimicrobial agents are commonly used for the treatment of paediatric illnesses like URTI, fever, UTI, infectious diarrheas, etc the presumed indications was taken from the working diagnosis as documented in the medical record instead of applying culture sensitivity reports as the basis of prescriptions. Antimicrobials prescriptions were used maximum in age groups of fi ve to 12 years which is similar to the study done in the Madhya Pradesh, India.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Prescription Pattern of Antimicrobial Agents in Hospitalised Paediatric Patients in a Tertiary Care Hospital of Kathmandu, Nepal

Khadka

Rayamajhi

Shrestha

2018

J. Nepal Paedtr. Soc.

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Introduction: Infectious diseases are one of the most frequent reasons for hospital admission for children and antimicrobials are commonly used to treat them. There is higher prevalence of irrational prescriptions of antimicrobials in such population. This study was conducted to survey the pattern of antimicrobial prescription in Paediatric inpatient. Material and Methods: This was retrospective, descriptive, observational study. The data was collected from prescription records. The paediatric population included in the study was categorised into three age groups. A total of 87 prescriptions were studied and the information was recorded in performa. Data were recorded in MS Excel and Graph Pad Prism version 6 was used for analysis. Results: The number of male child was outnumbered by female child. The average age of the patient on antimicrobial prescription was 5.34 ± 2.18 years. The mean duration of hospital stay was 6.17 ± 2.01 days. The common indications for antimicrobial prescriptions were upper respiratory tract infections, diarrhoeal illness, urinary tract infections, enteric fever, etc. The antimicrobials prescription rate was 1.33. Oral route was found to be commonly used than parenteral route. The generic prescription rate was 33.6%. The most common drug prescribed was ceftriaxone followed by amoxicillin + clavulanic acid, ciprofloxacin, metronidazole and amikacin. The 62.5% of antimicrobials were prescribed from National Essential List of Medicines. Conclusion: This study highlights the prescription pattern of antimicrobial agents in hospitalised Paediatric population in a tertiary care hospital.

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Length of paediatric inpatient stay, socio-economic status and hospital configuration: a retrospective cohort study

Cited by 15 publications

References 14 publications

Resource Use and Outcomes for Children Hospitalized With Severe Sepsis or Septic Shock

Resource Use and Outcomes for Children Hospitalized With Severe Sepsis or Septic Shock

Seasonal variations among admitted paediatric patients at tertiary care hospital, Gadap Town, Karachi, Pakistan

Evaluation of the Prescription Pattern of Antimicrobial Agents in Hospitalised Paediatric Patients in a Tertiary Care Hospital of Kathmandu, Nepal

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