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Costs and infant outcomes after implementation of a care process model for febrile infants

Carrie L Byington1, Carolyn C Reynolds, Kent Korgenski

  • 1Department of Pediatrics, University of Utah, Salt Lake City, Utah 84108, USA. carrie.byington@hsc.utah.edu

Pediatrics
|June 27, 2012
PubMed

Insights

An evidence-based care model improved febrile infant management, increasing appropriate diagnostic testing and antibiotic use while reducing hospital stays and costs. This approach enhanced infant outcomes without missing serious bacterial infections (SBI).

Area of Science:

  • Pediatrics
  • Infectious Disease Management
  • Healthcare Quality Improvement

Background:

  • Febrile infants under 90 days are at risk for serious bacterial infections (SBI), often indistinguishable from benign causes by examination alone.
  • Current care variations lead to both undertreatment and overtreatment of febrile infants.
  • Standardizing care for febrile infants is crucial for improving outcomes and resource utilization.

Purpose of the Study:

  • To develop and implement an evidence-based care process model (EB-CPM) for managing well-appearing febrile infants.
  • To evaluate the impact of the EB-CPM on care delivery, infant outcomes, and healthcare costs.
  • To assess the effectiveness of the EB-CPM in reducing unnecessary antibiotic use and hospitalizations.

Main Methods:

  • An observational study was conducted before and after EB-CPM implementation in a children's hospital and regional centers.
  • Data collected included diagnostic testing, antibiotic use, hospital length of stay, infant outcomes, and healthcare costs.
  • Statistical analysis compared outcomes and costs between pre- and post-EB-CPM periods.

Main Results:

  • Implementation of the EB-CPM led to increased evidence-based care, including appropriate diagnostics, risk assessment, and optimized antibiotic duration (P < .001).
  • Infant outcomes improved, with more confirmed SBI cases identified and low-risk infants managed without antibiotics (P < .001).
  • Hospital admissions decreased by 27% with no missed SBI cases, and healthcare costs reduced by 17% (P < .001).

Conclusions:

  • The EB-CPM successfully standardized and improved evidence-based care for febrile infants across all facilities.
  • The model enhanced infant outcomes, reduced healthcare costs, and improved overall value in managing febrile infants.
  • The EB-CPM demonstrates a successful strategy for optimizing the care of febrile infants, balancing safety and resource efficiency.
Abstract

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