Pediatric hospital care quality linked to patient population

To assess whether pediatric inpatient safety was associated with scarce hospital resources or with more severe and chronic conditions of the patient population, Linda Dynan, Ph.D., from the Cincinnati Children's Hospital Medical Center, and colleagues analyzed non-newborn pediatric inpatient hospital discharge records for 1,050 hospitals in 44 states in 2009 that met the criteria for potentially experiencing at least one pediatric quality indicator (PDI) event.

The researchers found that scarce resources, as assessed by high Medicaid burden, were not associated with the number of pediatric discharges with one or more PDI event. In contrast, PDI events were strongly predicted by illness severity (adjusted odds ratio high relative to low, 15.12) and the presence of chronic conditions in the population (adjusted odds ratio one relative to zero conditions, 1.78; relative to two or more conditions, 3.38).

"Our findings suggest that the patient population served, rather than hospital category, best predicts measured quality, underscoring the need for robust risk adjustment when incentivizing quality or comparing hospitals," Dynan and colleagues conclude. "Thus, problems of quality may not be systemic across hospital categories."

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Journal reference: Pediatrics

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