Revisit Rates Research Articles

Optimal acute care of the older adults

The emergency departments (ED) present as the gateway to healthcare services for an increasing number of older adults. Acute care of this vulnerable population in a busy ED presents its own unique challenge. They have higher mortality in the hospital and following discharge, a higher revisit rate to the ED, and are at a higher risk of functional decline following an ED visit. Extra caution and mindfulness are needed when caring for them as they differ from younger patients in several ways. This article tries to put forward feasible strategies with an integral and holistic view to meet their complex need in the ED.

The Effect of an Automated Mobile Patient Engagement Application on Emergency Department Revisits: Prospective Observational Study

BackgroundRevisits within 30 days to an emergency department (ED), observation care unit, or inpatient setting following patient discharge continue to be a challenge, especially in urban settings. In addition to the consequences for the patient, these revisits have a negative impact on a health system’s finances in a value-based care or global budget environment. LifeBridge Health, a community health system in Maryland, United States, implemented an automated mobile patient engagement application as part of our enterprise-wide digital health strategy to improve patient engagement and reduce revisits to the ED.ObjectiveThe aim of this paper was to evaluate the effectiveness of a customized automated digital patient engagement application (GetWell Loop) to reduce 30-day revisits after home discharge from an ED.MethodsThe LifeBridge Health Innovation Department and ED staff from 2 participating health system hospitals collaborated with GetWellNetwork to customize their patient engagement application with automated check-in questions and other on-demand resources (eg, streaming content explaining aspects of self-care during COVID-19). An application link was emailed to adult patients discharged home from the ED. A study of ED visits for patients treated for general medicine and cardiology conditions between August 1, 2018, and July 31, 2019, was conducted using CRISP (Chesapeake Regional Information System for our Patients), Maryland’s state-designated health information exchange. We also used data within GetWell Loop (GetWellNetwork) to track patient activation and engagement. The primary outcome was the number of ED patients who experienced a 30-day revisit and who did or did not activate their GetWell Loop account. Secondary outcomes included the overall activation rate and the rate of engagement as measured by the number of logins, alerts, and comments generated by patients through the application. Bivariate analysis comparing outcomes among patients who activated the GetWell Loop application to patients who did not was conducted using the Fisher exact test. Multivariate logistic regression modeling with elastic net regularization was also performed to account for potential confounders and potential collinearity of covariates.ResultsDuring this 1-year study, 1062 (27.4%) of 3866 of all emergency patients treated for general medicine or cardiology conditions, who received an invite to use the digital application, activated their account. The patients discharged from the ED, who were treated for general medicine conditions (n=2087) and who activated their GetWell Loop account, experienced a 30-day revisit rate of 17.3% (n=101) compared with 24.6% (n=369) for those who did not activate their account (P<.001). Of the patients treated for cardiology conditions (n=1779), 12.8% (n=61) of those who activated their GetWell account experienced a 30-day revisit compared with 17.7% (n=231) of those who did not activate their account (P=.01). The significance of these findings persisted after adjustment for confounding variables including age, race, sex, and payor in logistic regression modeling (adjusted odds ratio 0.75, 95% CI 0.62-0.92; P=.006).ConclusionsOur results suggest that a significant percentage of patients are willing to utilize a digital application following ED discharge to better engage in their own care, and that usage of such digital applications may significantly reduce 30-day revisit rates. LifeBridge Health’s experience demonstrates that health care systems can leverage automated mobile apps to improve patient engagement and successfully impact clinical outcomes at scale.

Accuracy of CREST Guideline in Management of Cellulitis in Emergency Department; a Systematic Review and Meta-analysis.

Introduction:Skin and soft tissue infections are important causes of outpatient visits to medical clinics or hospitals. This study aimed to review the literature for the accuracy of Clinical Resource Efficiency Support Team (CREST) guideline in management of cellulitis in emergency department. Method:Studies that had evaluated cellulitis patients using the CREST guideline were quarried in Scopus, Web of Science, and PubMed database, from 2005 to the end of 2020. The quality of the studies was evaluated using Scottish Intercollegiate Guideline Network (SIGN) checklist for cohort studies. Pooled area under the receiver operating characteristic curve (AUROC) of CREST guideline regarding the rate of hospital stay more than 24 hours, rate of revisit, and appropriateness of antimicrobial treatment in management of cellulitis in emergency department was evaluated.Results:Seven studies evaluating a total of 1640 adult cellulitis patients were finally entered to the study. In evaluation of the rate of the appropriate treatment versus over-treatment, the pooled AUROC was estimated to be 0.38 (95% confidence interval (CI): 0.06 – 0.82), indicating low accuracy (AUROC lower than 0.5) of guideline for antimicrobial choice. CREST II patients had a significantly lower odds ratio (OR) of revisiting the Emergency Department, OR=0.21 (95% CI: 0.009‎ – ‎ 0.47). Pooled AUROC value of 0.86 (CI95%: 0.84 – 0.89) showed accuracy of the CREST classification in prediction of being hospitalized more or less than 24 hours. Conclusion:CREST classification shows good accuracy in determining the duration of hospitalization or observation in ED but it could lead to inevitable over/under treatment with empirical antimicrobial agents.

Evaluation of Satellite Imagery for Monitoring Pacific Walruses at a Large Coastal Haulout

Pacific walruses (Odobenus rosmarus divergens) are using coastal haulouts in the Chukchi Sea more often and in larger numbers to rest between foraging bouts in late summer and autumn in recent years, because climate warming has reduced availability of sea ice that historically had provided resting platforms near their preferred benthic feeding grounds. With greater numbers of walruses hauling out in large aggregations, new opportunities are presented for monitoring the population. Here we evaluate different types of satellite imagery for detecting and delineating the peripheries of walrus aggregations at a commonly used haulout near Point Lay, Alaska, in 2018–2020. We evaluated optical and radar imagery ranging in pixel resolutions from 40 m to ~1 m: specifically, optical imagery from Landsat, Sentinel-2, Planet Labs, and DigitalGlobe, and synthetic aperture radar (SAR) imagery from Sentinel-1 and TerraSAR-X. Three observers independently examined satellite images to detect walrus aggregations and digitized their peripheries using visual interpretation. We compared interpretations between observers and to high-resolution (~2 cm) ortho-corrected imagery collected by a small unoccupied aerial system (UAS). Roughly two-thirds of the time, clouds precluded clear optical views of the study area from satellite. SAR was unaffected by clouds (and darkness) and provided unambiguous signatures of walrus aggregations at the Point Lay haulout. Among imagery types with 4–10 m resolution, observers unanimously agreed on all detections of walruses, and attained an average 65% overlap (sd 12.0, n 100) in their delineations of aggregation boundaries. For imagery with ~1 m resolution, overlap agreement was higher (mean 85%, sd 3.0, n 11). We found that optical satellite sensors with moderate resolution and high revisitation rates, such as PlanetScope and Sentinel-2, demonstrated robust and repeatable qualities for monitoring walrus haulouts, but temporal gaps between observations due to clouds were common. SAR imagery also demonstrated robust capabilities for monitoring the Point Lay haulout, but more research is needed to evaluate SAR at haulouts with more complex local terrain and beach substrates.

Hospital Revisits for Post-Ischemic Stroke Epilepsy after Acute Stroke Interventions

ObjectivesImprovements in acute stroke care have led to an increase in ischemic stroke survivors, who are at risk for development of post-ischemic stroke epilepsy (PISE). The impact of therapies such as thrombectomy and thrombolysis on risk of hospital revisits for PISE is unclear. We utilized administrative data to investigate the association between stroke treatment and PISE-related visits. Materials and methodsUsing claims data from California, New York, and Florida, we performed a retrospective analysis of adult survivors of acute ischemic strokes. Patients with history of epilepsy, trauma, infections, or tumors were excluded. Included patients were followed for a primary outcome of revisits for seizures or epilepsy. Cox proportional hazards regression was used to identify covariates associated with PISE. ResultsIn 595,545 included patients (median age 74 [IQR 21], 52% female), the 6-year cumulative rate of PISE-related revisit was 2.20% (95% CI 2.16-2.24). In multivariable models adjusting for demographics, comorbidities, and indicators of stroke severity, IV-tPA (HR 1.42, 95% CI 1.31-1.54, p<0.001) but not MT (HR 1.62, 95% CI 0.90-1.50, p=0.2) was associated with PISE-related revisit. Patients who underwent decompressive craniectomy experienced a 2-fold increase in odds for returning with PISE (HR 2.35, 95% CI 1.69-3.26, p<0.001). In-hospital seizures (HR 4.06, 95% CI 3.76-4.39, p<0.001) also elevated risk for PISE. SignificanceWe demonstrate that ischemic stroke survivors who received IV-tPA, underwent decompressive craniectomy, or experienced acute seizures were at increased risk PISE-related revisit. Close attention should be paid to these patients with increased potential for long-term development of and re-hospitalization for PISE.

IMPACT OF DESTINATION IMAGE ON REVISIT INTENTION MEDIATION ROLE BY OVERALL SATISFACTION PERSPECTIVE FROM SHOPPING DESTINATION IN BANDUNG, INDONESIA

Currently, the tourism sector is a central issue in the growth of a country. Researchers have proven the critical role of the tourism sector in increasing state revenues through tourist visits, both domestic and foreign tourists. Several previous studies have shown the part of the destination image in increasing the revisit rates. However, multiple research models have differed variations in explaining the influence of the destination image on the tourists' loyalty to revisit shopping destinations. Therefore, this study aims to determine the effect of destination image on tourist revisit intention towards shopping tours in Bandung. The survey approach is used to answer the research objectives. The results prove there is an influence of the destination image on the tourists' revisit intention to shopping tours with 179 samples carried out simultaneously on several shopping tourist destinations in Bandung. Thus, the proper advice to improve the revisit intention is providing facilities and infrastructure as well as exciting experiences for the tourists.

Trends in urological emergencies in the Era of COVID-19.

ABSTRACTPurpose:To evaluate trends in emergency room (ER) urological conditions during COVID-19 pandemic lockdown.Materials and Methods:Retrospective analyses of renal colic, hematuria, and urinary retention in ER's admissions of a tertiary hospital during the lockdown period (March 19 to May 4, 2020) in Israel. Patient's demographics and clinical characteristics were compared to those in corresponding periods during 2017-2019, with estimated changes in ER arrival and waiting times, utilization of imaging tests, numbers of hospitalizations, and urgent procedure rates.Results:The number of ER visits for renal colic, hematuria, and urinary retention decreased by 37%, from an average of 451 (2017-2019) to 261 patients (2020). Clinical severity was similar between groups, with no major differences in patient's age, vital signs, or laboratory results. The proportion of ER visits during night hours increased significantly during lockdown (44.8% vs. 34.2%, p=0.002). There was a decrease in renal colic admission rate from 19.8% to 8.4% (p=0.001) without differences in urgent procedures rates, while the 30-day revisit rate decreased from 15.8% to 10.3% during lockdown (p=0.02).Conclusions:General lockdown was accompanied by a significant decrease in common urological presentations to the ER. This change occurred across the clinical severity spectrum of renal colic, hematuria, and urinary retention. In the short term, it appears that patients who sought treatment did not suffer from complications that could be attributed to late arrival or delay in treatment. The long-term implications of abstinence from seeking emergent care are not known and require further investigation.

Acupuncture as adjunctive therapy for acute renal colic caused by urinary calculi: study protocol for a randomized controlled trial

BackgroundAcute renal colic caused by urinary calculi (ARCUC) has a considerable impact on the quality of life. Acupuncture might be a potential treatment option. However, the evidence is limited. We will conduct this trial to evaluate the efficacy and safety of acupuncture as adjunctive treatment to diclofenac for ARCUC.Methods/designA total of 80 eligible patients who are diagnosed with urinary stone renal colic will be randomly allocated to the acupuncture group or the sham acupuncture group. Each patient will receive 1 session of acupuncture or sham acupuncture. The primary outcome will be the response rate of patients achieving a reduction of > 50% on visual analog score (VAS) from baseline to 10 min after treatment. Secondary outcomes will include the VAS, remedial analgesia, re-visit and admission rate, blinding assessment, credibility and expectancy, and adverse event. All patients who receive randomization will be included in the intent-to-treat analysis.DiscussionThe finding of this trial will provide evidence on the efficacy and safety of acupuncture for the treatment of ARCUC. The results of this study will be published in peer-reviewed journals.Trial registrationClinicalTrials.gov ChiCTR 1900025202. Registered on August 16, 2019.

Emotional Labor and Place Attachment in Rural Tourism: The Mediating Role of Perceived Authenticity

Place attachment can effectively increase the revisit rate of tourists, which is significant for the sustainability of rural tourism. However, previous studies have rarely explored what kind of host-guest emotional closeness can promote tourist place attachment. This study explores the relationship between local residents&amp;rsquo; emotional labor strategy, perceived authenticity, and tourists&amp;rsquo; place attachment based on the rural tourism context. A total of 266 valid questionnaires were collected from rural tourists in Yantai as the research subjects by random sampling method. Structural equation modeling was applied to test the hypotheses. The results showed that local residents&amp;rsquo; deep acting positively influenced tourists&amp;rsquo; place attachment, and perceived authenticity partially mediated the relationship between the two. The negative effect of surface acting on rural tourists&amp;rsquo; place attachment was not significant.

The Influence of Service Factors on Customer Satisfaction in Makeup Salons

This study attempted to investigate the influence of makeup service factors on customer satisfaction empirically to provide basic data that would help makeup salons enhance customer satisfaction and set a proper direction for services. The results found the following: Among makeup service factors, ‘quality of cosmetics,’ ‘makeup artists’ skills,’ and ‘makeup artists’ reputation and kindness’ revealed a positive correlation with customer satisfaction with statistical significance. Also, ‘makeup artists’ reputation and kindness’ and ‘makeup artists’ skills’ positively affected customer satisfaction with statistical significance. The results confirm that ‘makeup artists’ reputation and kindness’ and ‘makeup artists’ skills’ have the greatest influence on customer satisfaction. The study results found that customer satisfaction with makeup services could be enhanced by increases in ‘reasonable service charge,’ ‘makeup artists’ skills,’ and ‘makeup artists’ reputation and kindness,’ thereby increasing revisit rates and making a significant contribution making makeup salons more competitive.

Cancer-related Emergency Department Visits: Comparing Characteristics and Outcomes.

IntroductionThere is increasing appreciation of the challenges of providing safe and appropriate care to cancer patients in the emergency department (ED). Our goal here was to assess which patient characteristics are associated with more frequent ED revisits.MethodsThis was a retrospective cohort study of all ED visits in California during the 2016 calendar year using data from the California Office of Statewide Health Planning and Development. We defined revisits as a return visit to an ED within seven days of the index visit. For both index and return visits, we assessed various patient characteristics, including age, cancer type, medical comorbidities, and ED disposition.ResultsAmong 12.9 million ED visits, we identified 73,465 adult cancer patients comprising 103,523 visits that met our inclusion criteria. Cancer patients had a 7-day revisit rate of 17.9% vs 13.2% for non-cancer patients. Cancer patients had a higher rate of admission upon 7-day revisit (36.7% vs 15.6%). Patients with cancers of the small intestine, stomach, and pancreas had the highest rate of 7-day revisits (22–24%). Cancer patients younger than 65 had a higher 7-day revisit rate than the elderly (20.0% vs 16.2%).ConclusionIn a review of all cancer-related ED visits in the state of California, we found a variety of characteristics associated with a higher rate of 7-day ED revisits. Our goal in this study was to inform future research to identify interventions on the index visit that may improve patient outcomes.

Advances in quantifying power plant CO2 emissions with OCO-2

We present CO2 emission estimates for twenty power plants and related facilities in the United States, India, South Africa, Poland, Russia and South Korea, derived from space-based CO2 observations from NASA's Orbiting Carbon Observatory 2 (OCO-2) satellite. Improvements to OCO-2 data quality and to our methodology yield improved results relative to earlier work. These new results include emission quantification for both larger and smaller power plants, the first power plant emission estimate based on ocean glint data and emissions from a small city with multiple industrial facilities. CO2 emission estimates are compared against reported facility emissions where available, including high temporal resolution data for the eight US sites. The difference with respect to reported values for the US sites ranges from 1.4% to 26.7%, with a mean of 15.1%, although the estimated emission sum for all US sites is within 0.8% of the reported value, suggesting the errors are largely random. This finding reinforces the importance of revisit rate for future space-based emission monitoring systems and furthermore confirms that making multiple overpasses of a power plant can reduce errors to an accuracy useful to support climate policy.

Age-related differences in revisits to the emergency departments of eight Korean university hospitals

• We aimed to study the ED revisit rate across different age groups. • Revisit rates differed across five different age groups. • Revisit rates increased with age. • Revisit rates of older adults were higher than those of younger adults. • Diagnosis and disposition during ED revisits also differed between age groups.

A clinical prediction model to identify children at risk for revisits with serious illness to the emergency department: A prospective multicentre observational study.

To develop a clinical prediction model to identify children at risk for revisits with serious illness to the emergency department. A secondary analysis of a prospective multicentre observational study in five European EDs (the TRIAGE study), including consecutive children aged <16 years who were discharged following their initial ED visit ('index' visit), in 2012-2015. Standardised data on patient characteristics, Manchester Triage System urgency classification, vital signs, clinical interventions and procedures were collected. The outcome measure was serious illness defined as hospital admission or PICU admission or death in ED after an unplanned revisit within 7 days of the index visit. Prediction models were developed using multivariable logistic regression using characteristics of the index visit to predict the likelihood of a revisit with a serious illness. The clinical model included day and time of presentation, season, age, gender, presenting problem, triage urgency, and vital signs. An extended model added laboratory investigations, imaging, and intravenous medications. Cross validation between the five sites was performed, and discrimination and calibration were assessed using random effects models. A digital calculator was constructed for clinical implementation. 7,891 children out of 98,561 children had a revisit to the ED (8.0%), of whom 1,026 children (1.0%) returned to the ED with a serious illness. Rates of revisits with serious illness varied between the hospitals (range 0.7-2.2%). The clinical model had a summary Area under the operating curve (AUC) of 0.70 (95% CI 0.65-0.74) and summary calibration slope of 0.83 (95% CI 0.67-0.99). 4,433 children (5%) had a risk of > = 3%, which was useful for ruling in a revisit with serious illness, with positive likelihood ratio 4.41 (95% CI 3.87-5.01) and specificity 0.96 (95% CI 0.95-0.96). 37,546 (39%) had a risk <0.5%, which was useful for ruling out a revisit with serious illness (negative likelihood ratio 0.30 (95% CI 0.25-0.35), sensitivity 0.88 (95% CI 0.86-0.90)). The extended model had an improved summary AUC of 0.71 (95% CI 0.68-0.75) and summary calibration slope of 0.84 (95% CI 0.71-0.97). As study limitations, variables on ethnicity and social deprivation could not be included, and only return visits to the original hospital and not to those of surrounding hospitals were recorded. We developed a prediction model and a digital calculator which can aid physicians identifying those children at highest and lowest risks for developing a serious illness after initial discharge from the ED, allowing for more targeted safety netting advice and follow-up.

Potential restorative effects of urban soundscapes: Personality traits, temperament, and perceptions of VR urban environments

This study investigated the potential restorative (PR) effects of urban soundscapes. To establish a new set of PR criteria for urban environments, this study recreated 10 urban sites in virtual reality, instead of using the typical method of questionnaires. A list of restoration-related semantic terms was derived from narrative interviews of 50 subjects who freely expressed their perceptions of the space. PR criteria were determined based on the derived list and two groups were found: the PR group and potential non-restorative group. The objective characteristics of urban soundscapes—acoustic and visual characteristics and characteristics of moving objects—were analyzed. Participants provided their subjective responses regarding sound source identification, perceived affective quality, and overall quality. The Temperament and Character Inventory-Revised-Short Version and Satisfaction with Life Scale were utilized to analyze participants’ individual characteristics. Based on it, a model was developed to predict whether PR criteria could be satisfied, which was 82.6% accurate (85.9% specificity, 71.8% sensitivity). It was determined that the overall level of preference regarding an urban soundscape is a significant factor in satisfying PR criteria. In particular, the design and planning of urban spaces should aim to reduce a space’s loudness and increase the revisitation rate to promote the restoration of the urban residents’ mental health. Furthermore, for individuals, a trait based on acquired experience has a greater impact on the PR effects of urban soundscapes than innate temperament. This study’s findings can serve as supporting data to design sustainable and health-promoting urban soundscapes.

Effect of a health system payment and quality improvement programme for tonsillectomy in Ontario, Canada: an interrupted time series analysis

BackgroundTonsillectomy is among the most common and cumulatively expensive surgical procedures in children, with known variations in quality of care. However, evidence on health system interventions to improve quality of...

Important Factors Affecting Rural Tourists’ Aesthetic Experience: A Case Study of Zoumatang Village in Ningbo

China’s countryside is rich in cultural heritage. It is an important engine for rural development and revitalization. How to improve the tourists’ satisfaction with their aesthetic experience, raise the revisit rate and loyalty, and provide new methods and ideas for re-understanding the tourism experience is a topic worth discussing. This study chose Zoumatang Village in Ningbo, China, as the research target, and explored the important factors affecting tourists’ satisfaction with the aesthetic experience of their visit. Through a literature review and eight experts applying the Delphi method, this paper develops a framework of important criteria for the Zoumatang Village aesthetic experience. It then ranks their importance and causal relationships using the DEMATEL-based ANP method. It also combines 16 important factors for tourist satisfaction to explore improvement measures. The research results show that pleasure is the most critical factor of the aesthetic experience offered by Zoumatang Village with interactivity, variety, associability, sociability, and stewardship as factors that need to be improved given that naturalness lies at the heart of tourists’ aesthetic experience. The evaluation model of this study can provide a reference for improving the aesthetic experience of Zoumatang Village in particular, and the research methods and ideas for rural tourism development planning and integrated marketing in general. The findings can be used when investigating aesthetic experience, questionnaire making, and evaluation optimization related to tourism.

Community socioeconomic disadvantage drives type of 30-day medical-surgical revisits among patients with serious mental illness

BackgroundPatients with serious mental illness (SMI) are vulnerable to medical-surgical readmissions and emergency department visits.MethodsWe studied 1,914,619 patients with SMI discharged after medical-surgical admissions in Florida and New York between 2012 and 2015 and their revisits to the hospital within 30 days of discharge.ResultsPatients with SMI from the most disadvantaged communities had greater adjusted 30-day revisit rates than patients from less disadvantaged communities. Among those that experienced a revisit, patients from the most disadvantaged communities had 7.3 % greater 30-day observation stay revisits.ConclusionsThese results suggest that additional investments are needed to ensure that patients with SMI from the most disadvantaged communities are receiving appropriate post-discharge care.

Pediatric Tracheostomy Outcomes After Development of a Multidisciplinary Airway Team: A Quality Improvement Initiative

ObjectivesTo analyze a multidisciplinary tracheostomy team’s effect on length of stay and cost.MethodsAn airway management program using a balanced scorecard was created to track key performance measures. Interventions included weekly rounding, standardized placement, postoperative care, and caregiver education. Process measures included time to first education, speech-language pathology consultation rates, and pretracheostomy consultations. Outcome measures focused on the total length of stay, 30-day revisit rates after discharge, accidental decannulation rate, and standardized cost. Regression analysis was used to predict the program’s effect on length of stay and total cost.ResultsIn total, 239 children met inclusion. The mean time to first education class was reduced from 13.7 to 1.9 days (P < .001). The speech-language pathology consultation rate increased from 68% to 95% (P < .001), and the presurgical consultation rate with the tracheostomy team increased from 14% to 93% (P < .001). The length of stay decreased from 133 to 96 days (P = .006). Total costs were lower for short admissions but higher for prolonged admissions. Revisits within 30 days remained stable over time (18%).DiscussionEstablishing a multidisciplinary tracheostomy team results in improvements in quality metrics when caring for children with tracheostomies. Controlling for associated factors showed the mean length of stay decreased significantly in the first full year of program implementation. Cost analysis estimated significant reductions for tracheostomy patients spending less time in the hospital.Implications for PracticeA airway management program can positively affect tracheostomy processes and outcomes.

Outcomes Associated With High- Versus Low-Frequency Laboratory Testing Among Hospitalized Children.

Previous pediatric studies have revealed substantial variation in laboratory testing for specific conditions, but clinical outcomes associated with high- versus low-frequency testing are unclear. We hypothesized that hospitals with high- versus low-testing frequency would have worse clinical outcomes. We conducted a multicenter retrospective cohort study of patients 0 to 18 years old with low-acuity hospitalizations in the years 2018-2019 for 1 of 10 common All Patient Refined Diagnosis Related Groups. We identified hospitals with high-, moderate-, and low-frequency testing for 3 common groups of laboratory tests: complete blood cell count, basic chemistry studies, and inflammatory markers. Outcomes included length of stay, 7- and 30-day emergency department revisit and readmission rates, and hospital costs, comparing hospitals with high- versus low-frequency testing. We identified 132 391 study encounters across 44 hospitals. Laboratory testing frequency varied by hospital and condition. We identified hospitals with high- (13), moderate- (20), and low-frequency (11) laboratory testing. When we compared hospitals with high- versus low-frequency testing, there were no differences in adjusted hospital costs (rate ratio 0.89; 95% confidence interval 0.71-1.12), length of stay (rate ratio 0.98; 95% confidence interval 0.91-1.06), 7-day (odds ratio 0.99; 95% confidence interval 0.81-1.21) or 30-day (odds ratio 1.01; 95% confidence interval 0.82-1.25) emergency department revisit rates, or 7-day (odds ratio 0.84; 95% confidence interval 0.65-1.25) or 30-day (odds ratio 0.91; 95% confidence interval 0.76-1.09) readmission rates. In a multicenter study of children hospitalized for common low-acuity conditions, laboratory testing frequency varied widely across hospitals, without substantial differences in outcomes. Our results suggest opportunities to reduce laboratory overuse across conditions and children's hospitals.