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Specific administrative data can serve as benchmarks for pediatric asthma care
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Administrative data on chest radiograph utilization, antibiotic administration, and blood cell count utilization can be used as achievable benchmarks for inpatient care for asthma, bronchiolitis, and pneumonia, according to study findings in Pediatrics.
Kavita Parikh, MD, MSHS, of the division of hospitalist medicine, department of pediatrics, George Washington School of Medicine in Washington, D.C., used data from the Pediatric Health Information System to evaluate hospitals’ resource utilization for children receiving care for asthma, bronchiolitis, and pneumonia from January 2012 to December 2012. The study cohort included children aged 2 to 18 years with a primary diagnosis of asthma, children aged 2 months to 2 years with bronchiolitis, and children aged 2 months to 18 years with pneumonia. A 3-step method was used to define achievable benchmarks of care. First, hospitals were ranked based on desired performance on a measure; second, best performing hospitals that comprised 10% of the total patient population for each quality indicator were selected; and third, benchmarks were the sum of the numerators divided by the sum of denominators.
Kavita Parikh
Based on data for 50,051 patient encounters with asthma, bronchiolitis, or pneumonia, achievable benchmarks for asthma care are chest radiograph utilization, antibiotic administration, and ipratropium bromide use for more than 2 days. Achievable benchmarks of care for bronchiolitis are chest radiograph utilization, viral testing, antibiotic administration, bronchodilator use for more than 2 days, and steroid use. Complete blood cell count utilization, viral testing, initial narrow-spectrum antibiotic use, erythrocyte sedimentation rate, and C-reactive protein are achievable benchmarks for pneumonia.
“We have demonstrated that administrative data can be used to calculate achievable benchmarks of care for the top three admission diagnoses in pediatric hospital care. These achievable benchmarks of care represent measurable and attainable goals for standardization of care, and they can be the starting point for individual hospitals to evaluate their performance to a national standard,” the researchers concluded.
Disclosure: The researchers report no relevant financial disclosures.
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