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Iatrogenic risks and financial costs of hospitalizing febrile infants
Insights
Hospitalizing febrile infants under 60 days leads to significant iatrogenic complications and financial costs. Many complications, particularly from intravenous therapy, were preventable and some infants may not have needed admission.
Area of Science:
- Pediatrics
- Hospital Medicine
- Health Economics
Background:
- Hospitalization of febrile infants under 60 days is common.
- Assessing the iatrogenic and financial burdens associated with these admissions is crucial for optimizing care.
Purpose of the Study:
- To identify and quantify the iatrogenic complications and financial costs associated with hospitalizing febrile infants aged 60 days or younger.
- To determine the preventability of identified complications and assess the necessity of hospitalization for some infants.
Main Methods:
- Diagnostic categories were used to analyze hospital admissions for febrile infants (≤60 days).
- Data collected included complications, their causes, preventability, and necessity of hospitalization.
- Financial costs, length of stay, and cost breakdowns (diagnostic studies, physician fees) were analyzed.
Main Results:
- Thirty-seven percent of admissions resulted in 48 complications, with 60.4% deemed preventable.
- Twelve percent of complications occurred in infants who likely did not require hospitalization.
- Intravenous therapy accounted for 50% of complications; 26 diagnostic misadventures were also noted. Average hospitalization cost was $2,130 (1979-80 dollars).
Conclusions:
- Hospitalizing febrile infants under 60 days incurs substantial iatrogenic risks and financial costs.
- A significant proportion of complications are preventable, suggesting potential for improved clinical practice and resource allocation.
- The findings highlight the need for careful evaluation of hospitalization necessity and optimization of treatment protocols in this vulnerable population.
Abstract:
We identified, by diagnostic categories, the iatrogenic and financial costs that arise from hospitalizing febrile infants 60 days of age or younger. Thirty-seven (19.5%) of all admissions resulted in 48 separate complications. Twenty-nine (60.4%) of these complications were preventable, and six complications (12.5%) occurred in infants who probably did not require hospitalization for therapy. Twenty-four (50%) of all complications resulted from intravenous therapy. In addition to the complications, 26 diagnostic misadventures were identified. The average length of hospitalization for all infants was 7.0 days, with a range of two to 28 days. The average cost of hospitalization in 1979-80 dollars was $2,130 per infant, with a range from $6,345 for those infants with bacterial meningitis to $1,480 for those infants with aseptic meningitis. On the average, 25.6% of the bill was for diagnostic studies and 8.3% for physician fees.