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Unnecessary care for bronchiolitis decreases with increasing inpatient prevalence of bronchiolitis

William C Van Cleve1, Dimitri A Christakis

  • 1Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington, USA. vancleve@uw.edu

Pediatrics
|October 12, 2011
PubMed

Insights

Higher inpatient bronchiolitis prevalence (IBP) correlated with decreased unnecessary treatments like steroids and radiographs for hospitalized infants. This suggests context influences care delivery for acute illnesses.

Area of Science:

  • Pediatric hospital medicine
  • Health services research
  • Epidemiology

Background:

  • Bronchiolitis is a common pediatric hospitalization diagnosis.
  • Unnecessary tests and treatments are frequently administered to patients with bronchiolitis.
  • Inpatient bronchiolitis prevalence (IBP) may influence care delivery patterns.

Purpose of the Study:

  • To examine the association between inpatient bronchiolitis prevalence (IBP) and the utilization of potentially unnecessary medical interventions for hospitalized patients diagnosed with bronchiolitis.

Main Methods:

  • A retrospective cohort study analyzed data from the Pediatric Hospital Information System database (2004-2008).
  • Included were patients aged 2 months to 2 years hospitalized with bronchiolitis.
  • Outcomes measured included the probability of receiving steroids, intravenous antibiotics, radiographs, and laboratory tests.

Main Results:

  • An increase in IBP was associated with a decreased likelihood of receiving steroids, radiographs, and laboratory tests during winter months.
  • Similar associations for steroids and radiographs were observed during summer months.
  • No significant association was found between IBP and antibiotic use in either season.

Conclusions:

  • Increasing inpatient bronchiolitis prevalence appears to correlate with reduced delivery of certain unnecessary treatments.
  • This suggests that contextual factors, such as prevalence, impact clinical decision-making in acute pediatric illness.
  • Understanding these associations is crucial for optimizing high-quality healthcare delivery.
Abstract

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