Variation in Diagnostic Testing and Hospitalization Rates in Children With Acute Gastroenteritis.

Abstract

Acute gastroenteritis (AGE) remains a major cause of childhood morbidity and mortality in the United States. The routine use of vaccines targeting rotavirus, the most common cause of pediatric AGE, has decreased all-cause AGE emergency department (ED) visits and hospitalizations.1 However, the burden of pediatric AGE remains substantial. With annual hospitalization rates of 3 to 5 per 1000 US children $350 million in costs annually.3 Care for uncomplicated AGE is largely supportive, and guidelines from the American Academy of Pediatrics and other international organizations emphasize conservative management and discourage routine diagnostic testing for AGE, with or without dehydration.4–6 Yet there continues to be wide variation in AGE management among individual providers and hospitals in the United States and abroad.7,8 Studies in children with acute respiratory illness show similar variation in care that is associated with important outcome differences, with higher resource utilization linked to higher rates of hospitalization and longer hospital length of stay (LOS), irrespective of the severity of illness.9,10 Whether similar associations exist between resource utilization and outcomes in children with AGE is largely unexplored. With the use of data from 34 US children’s hospitals, we sought …