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The relationship between pediatric residency program size and inpatient illness severity and diversity

Rebecca M Jennings1, Lindsay A Thompson, Charles L Townsend

  • 1Center for the Evaluative Clinical Sciences and the Department of Community and Family Medicine, Dartmouth Medical School, Hanover, NH, USA.

Archives of Pediatrics & Adolescent Medicine
|July 16, 2003
PubMed

Insights

Pediatric residency programs show significant variation in patient illness severity and diagnostic diversity, regardless of program size. This suggests program size is not a reliable indicator of inpatient learning experiences for trainees.

Area of Science:

  • Medical Education
  • Pediatric Residency Training
  • Healthcare Quality

Background:

  • Pediatric residency requires exposure to diverse hospitalized patients for comprehensive training.
  • Limited understanding exists regarding variations in pediatric inpatient educational experiences across different residency programs.

Purpose of the Study:

  • To investigate differences in inpatient illness severity and diagnostic diversity among affiliated hospitals of small, medium, and large pediatric residency programs.

Main Methods:

  • Retrospective analysis of pediatric hospital discharges (excluding newborns) from the University HealthSystems Consortium.
  • Compared mean and median Diagnosis-Related Group (DRG) weights for illness severity.
  • Assessed diagnostic diversity by analyzing the proportion of discharges for the 5 most common diagnoses and asthma.

Main Results:

  • No significant difference in medical illness severity (DRG weights) was found across residency program sizes.
  • Larger programs had more severe surgical patients but less diagnostic diversity.
  • The proportion of asthma discharges increased with residency program size.

Conclusions:

  • Significant variations in inpatient illness severity and diagnostic diversity exist across pediatric residency programs.
  • Program size is not a strong predictor of the quality or breadth of inpatient learning opportunities for residents.
Abstract

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