Document Detail

Identification of potentially avoidable pediatric hospital use: admitting physician judgment as a complement to utilization review.
MedLine Citation:
PMID:  7936847     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine, for acute general pediatric admissions, 1) the proportion of admissions that the admitting physician would identify as potentially avoidable; 2) services that might help reduce avoidable admissions; 3) potential savings in hospital days through eliminating avoidable admissions; 4) the role that social factors play in admission decisions; and 5) if admitting physician judgment provides a valuable complement to Utilization Review (UR) in identifying avoidable admissions. METHODS: A questionnaire was used to determine the proportion of 600 acute general pediatric admissions considered potentially avoidable by the admitting physician and to identify services required to prevent such admissions. Savings through eliminating potentially avoidable admissions and social factors influencing admission decisions were examined. Physicians' and UR assessments of necessity of inpatient care were compared. RESULTS: Admitting physicians judged 28% of admissions as potentially avoidable, citing alternative services for each avoidable admission. Eliminating all avoidable admissions would have reduced hospital days by 7.7%. Physicians identified 6% of admissions as social admissions, most commonly due to an overwhelmed family. UR identified 1% of potentially avoidable admissions as unnecessary. CONCLUSION: Incorporating admitting physician judgment may significantly improve current efforts to identify and reduce avoidable hospital use.
J L Soulen; A K Duggan; C D DeAngelis
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatrics     Volume:  94     ISSN:  0031-4005     ISO Abbreviation:  Pediatrics     Publication Date:  1994 Oct 
Date Detail:
Created Date:  1994-10-26     Completed Date:  1994-10-26     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  421-4     Citation Subset:  AIM; IM    
Dept of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD.
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MeSH Terms
Acute Disease
Child, Preschool
Cost Savings
Health Policy
Health Services Misuse / economics,  statistics & numerical data*
Health Services Research
Hospitals, Pediatric / economics,  utilization*
Length of Stay / economics,  statistics & numerical data
Patient Admission / statistics & numerical data*
Physician's Role*
Socioeconomic Factors
Utilization Review*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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