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Hospital-Level Variation in Practice Patterns and Patient Outcomes for Pediatric Patients Hospitalized With

Jamie Librizzi1, Samuel Flores2, Keith Morse2

  • 1Department of Pediatric Hospital Medicine, Phoenix Children's Hospital, Phoenix, Arizona; and jlibrizzi@phoenixchildrens.com.

Hospital Pediatrics
|May 20, 2017
PubMed

Insights

Hospitalized pediatric constipation management varies widely across US children's hospitals. Standardizing care with evidence-based guidelines is recommended to improve outcomes for functional constipation in children.

Area of Science:

  • Pediatric Gastroenterology
  • Hospital Medicine
  • Clinical Practice Patterns

Background:

  • Functional constipation affects 3-5% of children aged 4-17 years.
  • No current evidence-based guidelines exist for managing hospitalized pediatric constipation.
  • This study evaluates current practices and outcomes in US children's hospitals.

Purpose of the Study:

  • To assess practice variations in managing hospitalized pediatric functional constipation.
  • To analyze patient outcomes associated with current management strategies.
  • To identify areas for improvement in hospital care for pediatric constipation.

Main Methods:

  • Multicenter, retrospective cohort study (2012-2014).
  • Included children (0-18 years) hospitalized for functional constipation using ICD-9 codes.
  • Excluded patients with complex chronic conditions; analyzed therapies, length of stay, and readmission rates.

Main Results:

  • 14,243 hospitalizations analyzed; 0.65% of admissions were for functional constipation.
  • Wide variation in treatments used: electrolyte laxatives (40-96%), sodium phosphate enema (0-64%), etc.
  • Mean length of stay was 1.97 days; mean 90-day readmission rate was 3.78%.

Conclusions:

  • Significant variability exists in pediatric functional constipation management and outcomes across US hospitals.
  • Lack of standardized, evidence-based guidelines contributes to practice variation.
  • Adopting best practices could standardize care and improve outcomes for hospitalized children.
Abstract

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