A cost-saving algorithm for children hospitalized for status asthmaticus. McDowell KM, Chatburn RL, Myers TR, O'Riordan M, & Kercsmar CM Archives of Pediatrics & Adolescent Medicine, 152(10):977–984, October, 1998.
Paper doi abstract bibtex Objective To test the ability of an assessment-driven algorithm for treatment of pediatric status asthmaticus to reduce length and cost of hospitalization.Design Nonrandomized, prospective, controlled trial.Setting Tertiary care children's hospital.Patients Children aged 1 to 18 years hospitalized for status asthmaticus; 104 were treated using the asthma care algorithm (intervention) and 97 using unstructured standard treatment (control).Intervention Patients were treated using either an assessment-based algorithm or standard care practices. The algorithm group was treated with standard medications (aerosolized albuterol, systemic corticosteroids, epinephrine, ipratropium) administered at a frequency driven by the patient's clinical condition. Specific criteria were outlined for decreasing or augmenting therapy, transferring to intensive care, and discharging to home. A unique patient record containing assessments, algorithm cues, and a treatment record was used. Intervention group patients were interviewed by telephone 1 week after discharge.Main Outcome Measures Hospital length of stay, cost per hospitalization, relapse rate, protocol adherence.Results Average hospital stay for intervention patients was significantly shorter than for control patients (2.0 vs 2.9 days, P\textless.001). Although intervention patients received fewer aerosolized albuterol doses than controls, there was no difference in short-term relapse rate between groups. The intervention saved more than $700 per patient in hospital charges. Adherence to the protocol was excellent, with only 8 variances per patient stay out of more than 150 opportunities.Conclusion An intensive, assessment-driven algorithm for pediatric status asthmaticus significantly reduces hospital length of stay and costs without increasing morbidity.
@article{mcdowell_km_cost-saving_1998,
title = {A cost-saving algorithm for children hospitalized for status asthmaticus},
volume = {152},
issn = {1072-4710},
url = {http://dx.doi.org/10.1001/archpedi.152.10.977},
doi = {10.1001/archpedi.152.10.977},
abstract = {Objective
To test the ability of an assessment-driven algorithm for treatment of pediatric status asthmaticus to reduce length and cost of hospitalization.Design
Nonrandomized, prospective, controlled trial.Setting
Tertiary care children's hospital.Patients
Children aged 1 to 18 years hospitalized for status asthmaticus; 104 were treated using the asthma care algorithm (intervention) and 97 using unstructured standard treatment (control).Intervention
Patients were treated using either an assessment-based algorithm or standard care practices. The algorithm group was treated with standard medications (aerosolized albuterol, systemic corticosteroids, epinephrine, ipratropium) administered at a frequency driven by the patient's clinical condition. Specific criteria were outlined for decreasing or augmenting therapy, transferring to intensive care, and discharging to home. A unique patient record containing assessments, algorithm cues, and a treatment record was used. Intervention group patients were interviewed by telephone 1 week after discharge.Main Outcome Measures
Hospital length of stay, cost per hospitalization, relapse rate, protocol adherence.Results
Average hospital stay for intervention patients was significantly shorter than for control patients (2.0 vs 2.9 days, P{\textless}.001). Although intervention patients received fewer aerosolized albuterol doses than controls, there was no difference in short-term relapse rate between groups. The intervention saved more than \$700 per patient in hospital charges. Adherence to the protocol was excellent, with only 8 variances per patient stay out of more than 150 opportunities.Conclusion
An intensive, assessment-driven algorithm for pediatric status asthmaticus significantly reduces hospital length of stay and costs without increasing morbidity.},
number = {10},
urldate = {2014-09-29},
journal = {Archives of Pediatrics \& Adolescent Medicine},
author = {{McDowell KM} and {Chatburn RL} and {Myers TR} and {O'Riordan M} and {Kercsmar CM}},
month = oct,
year = {1998},
pages = {977--984},
}
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The algorithm group was treated with standard medications (aerosolized albuterol, systemic corticosteroids, epinephrine, ipratropium) administered at a frequency driven by the patient's clinical condition. Specific criteria were outlined for decreasing or augmenting therapy, transferring to intensive care, and discharging to home. A unique patient record containing assessments, algorithm cues, and a treatment record was used. Intervention group patients were interviewed by telephone 1 week after discharge.Main Outcome Measures Hospital length of stay, cost per hospitalization, relapse rate, protocol adherence.Results Average hospital stay for intervention patients was significantly shorter than for control patients (2.0 vs 2.9 days, P\\textless.001). Although intervention patients received fewer aerosolized albuterol doses than controls, there was no difference in short-term relapse rate between groups. The intervention saved more than $700 per patient in hospital charges. Adherence to the protocol was excellent, with only 8 variances per patient stay out of more than 150 opportunities.Conclusion An intensive, assessment-driven algorithm for pediatric status asthmaticus significantly reduces hospital length of stay and costs without increasing morbidity.","number":"10","urldate":"2014-09-29","journal":"Archives of Pediatrics & Adolescent Medicine","author":[{"firstnames":[],"propositions":[],"lastnames":["McDowell KM"],"suffixes":[]},{"firstnames":[],"propositions":[],"lastnames":["Chatburn RL"],"suffixes":[]},{"firstnames":[],"propositions":[],"lastnames":["Myers TR"],"suffixes":[]},{"firstnames":[],"propositions":[],"lastnames":["O'Riordan M"],"suffixes":[]},{"firstnames":[],"propositions":[],"lastnames":["Kercsmar CM"],"suffixes":[]}],"month":"October","year":"1998","pages":"977–984","bibtex":"@article{mcdowell_km_cost-saving_1998,\n\ttitle = {A cost-saving algorithm for children hospitalized for status asthmaticus},\n\tvolume = {152},\n\tissn = {1072-4710},\n\turl = {http://dx.doi.org/10.1001/archpedi.152.10.977},\n\tdoi = {10.1001/archpedi.152.10.977},\n\tabstract = {Objective \nTo test the ability of an assessment-driven algorithm for treatment of pediatric status asthmaticus to reduce length and cost of hospitalization.Design\nNonrandomized, prospective, controlled trial.Setting\nTertiary care children's hospital.Patients\nChildren aged 1 to 18 years hospitalized for status asthmaticus; 104 were treated using the asthma care algorithm (intervention) and 97 using unstructured standard treatment (control).Intervention\nPatients were treated using either an assessment-based algorithm or standard care practices. The algorithm group was treated with standard medications (aerosolized albuterol, systemic corticosteroids, epinephrine, ipratropium) administered at a frequency driven by the patient's clinical condition. Specific criteria were outlined for decreasing or augmenting therapy, transferring to intensive care, and discharging to home. A unique patient record containing assessments, algorithm cues, and a treatment record was used. Intervention group patients were interviewed by telephone 1 week after discharge.Main Outcome Measures\nHospital length of stay, cost per hospitalization, relapse rate, protocol adherence.Results\nAverage hospital stay for intervention patients was significantly shorter than for control patients (2.0 vs 2.9 days, P{\\textless}.001). Although intervention patients received fewer aerosolized albuterol doses than controls, there was no difference in short-term relapse rate between groups. The intervention saved more than \\$700 per patient in hospital charges. 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