Factors Associated with Variability in Outcomes for Children Hospitalized with Urinary Tract Infection
This article examines the range of care received by children hospitalized with urinary tract infections. Urinary tract infection is one of the most common causes of hospitalization among children under age 12 in the United States.
The authors examined the records of a cohort of 20,892 children at 25 children's hospitals between 1999 and 2004. They measured variability in length of stay, imaging, costs and readmission.
- There were significant differences across hospitals on average length of stay, imaging frequency and other outcomes and processes of care.
- Older children had shorter hospitalizations and were less likely to undergo imaging than younger children.
- Patients at high volume hospitals were more likely to receive imaging. Patients at hospitals with high percentage of Medicaid patients were less likely to receive imaging and more likely to have a longer hospitalization.
- Hospitals with clinical practice guidelines for urinary tract infections had shorter average length of stays and lower costs per admission.
The range of processes and outcomes for children's urinary tract infections presents an opportunity for standardization and quality improvement across hospitals.