Vast Treatment Differences Exist Among Pediatric Asthma Patients

A recent study found that the management of inpatients with asthma varies greatly among children’s hospitals, even when other characteristics are taken into account.

“Although there are well-established clinical pathways for treating children with asthma, we found significant differences in how tertiary-care pediatric hospitals used their resources,” said study leader Jeffrey H. Silber, MD, PhD. “However, this auditing method offers hospitals some guidance in identifying practice styles that could improve their care.”

The hospitals were found to be different in costs, length of inpatient stay, and time spent in the intensive care unit (ICU), according to a study published by JAMA Pediatrics. The researchers analyzed data from 49,000 pediatric patients with asthma hospitalized between 2011 and 2014.

The study included a tool called “temple matching” to group patients by characteristics in order to create templates that could then be compared against other templates, according to the study. This system could create a more accurate way to audit hospital costs and resource use.

It also allows administrators to analyze hospital resource use at a patient level, and determine whether similar patients are receiving similar treatments. Researchers discovered the cost varied by 87% between similar patients, and length of stay varied by 47%.

They also found that resource use among patients was different between each hospital. Costs for higher-risk patients had significantly higher resource use in some hospitals, while the opposite was happening in other hospitals, according to the study.

“As the most prevalent chronic illness in children, asthma imposes a major financial burden on many health care systems,” Dr Silber concluded. “If hospitals can better understand if their care practices are disproportionately expensive and inefficient compared to other hospitals, they may be better able to pinpoint opportunities for quality improvements.”