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Variation in practice patterns and resource utilization surrounding management of intussusception at freestanding

Samuel Rice-Townsend1, Catherine Chen, Jeff N Barnes

  • 1Department of Pediatric Surgery, Children's Hospital Boston, Harvard Medical School, Boston, MA 02115, USA. shawn.rangel@childrens.harvard.edu

Journal of Pediatric Surgery
|January 22, 2013
PubMed

Insights

Pediatric intussusception management varies widely across children's hospitals, impacting costs and outcomes. Standardizing care through collaborative quality improvement is recommended for cost-effective treatment.

Area of Science:

  • Pediatric Surgery
  • Healthcare Management
  • Clinical Practice Variation

Background:

  • Intussusception is a common pediatric surgical emergency.
  • Management strategies and resource utilization for intussusception can differ significantly among healthcare institutions.

Purpose of the Study:

  • To analyze and characterize the variations in clinical practice patterns and resource utilization for intussusception management across children's hospitals.
  • To identify differences in operative rates, antibiotic use, discharge timing, readmissions, and costs associated with intussusception care.

Main Methods:

  • Retrospective cohort study utilizing data from 27 children's hospitals within the Pediatric Health Information System database.
  • Analysis covered the period from January 1, 2009, to June 30, 2011.
  • Hospitals were compared based on rates of operative management, prophylactic antibiotic use, same-day discharge, 48-hour readmission rates, and associated costs and charges.

Main Results:

  • A total of 2544 patients with intussusception were analyzed.
  • Significant inter-hospital variability was observed in the rate of surgery after attempted enema reduction (11%-62.8%).
  • Substantial variation also existed in prophylactic antibiotic use (1.4%-93.2%), same-day discharge rates (0%-83.8%), 48-hour readmission rates (5.3%-32.1%), and treatment-related costs and charges.

Conclusions:

  • There are significant disparities in practice patterns and resource utilization for pediatric intussusception management among children's hospitals.
  • Further research through prospective analysis and collaborative quality improvement initiatives is needed to establish best-practice guidelines.
  • Optimizing care for intussusception can lead to more cost-effective and standardized treatment outcomes.
Abstract

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