Inpatient care for uncomplicated bronchiolitis: Comparison with Milliman and Robertson guidelines

Narendra M. Kini, James M. Robbins, Mark S. Kirschbaum, Stephanie J. Frisbee, Uma R. Kotagal

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Context: Bronchiolitis is the most common lower respiratory tract infection in infancy. A recent Centers for Disease Control and Prevention report confirmed that hospitalization rates for bronchiolitis have increased 2.4-fold from 1980 to 1996. Controversies exist about optimal treatment plans. Milliman and Robertson recommend ambulatory care management; in case of hospitalization, the recommended length of stay is 1 day. Objectives: To relate actual practice variation for infants admitted with uncomplicated bronchiolitis to Milliman and Robertson's recommendations. Design: Prospective observational study. Setting: General care wards of 8 pediatric hospitals of the Child Health Accountability Initiative during the winter of 1998-1999. Patients: First-time admissions for uncomplicated bronchiolitis in patients not previously diagnosed as having asthma and who were younger than 1 year. Main Outcome Measures: Respiratory rate, monitored interventions, attainment of discharge criteria goals, and length of stay. Results: Eight hundred forty-six patients were included in the final analysis: 85.7% were younger than 6 months, 48.5% were nonwhite, and 64.1% were Medicaid recipients or self-pay. On admission to the hospital, 18.3% of the infants had respiratory rates higher than higher than 80 breaths per minute, 53.8% received supplemental oxygen therapy, and 52.6% received intravenous fluids. These proportions decreased to 1.9%, 33.8%, and 20.3%, respectively, 1 day after admission, and to 0.7%, 20.1%, and 8.6%, respectively, 2 days after admission. The average length of stay was 2.8 days (SD, 2.3 days). Conclusions: Milliman and Robertson's recommendations do not correspond to practice patterns observed at the hospitals participating in this study; no hospital met the Milliman and Robertson recommended 1-day goal length of stay. Administration of monitored intervention persisted past the second day of hospitalization.

Original languageEnglish (US)
Pages (from-to)1323-1327
Number of pages5
JournalArchives of Pediatrics and Adolescent Medicine
Volume155
Issue number12
StatePublished - 2001
Externally publishedYes

Fingerprint

Bronchiolitis
Inpatients
Length of Stay
Guidelines
Hospitalization
Respiratory Rate
Patients' Rooms
Pediatric Hospitals
Social Responsibility
Medicaid
Centers for Disease Control and Prevention (U.S.)
Ambulatory Care
Respiratory Tract Infections
Observational Studies
Asthma
Outcome Assessment (Health Care)
Prospective Studies
Oxygen
Therapeutics

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Kini, N. M., Robbins, J. M., Kirschbaum, M. S., Frisbee, S. J., & Kotagal, U. R. (2001). Inpatient care for uncomplicated bronchiolitis: Comparison with Milliman and Robertson guidelines. Archives of Pediatrics and Adolescent Medicine, 155(12), 1323-1327.

Inpatient care for uncomplicated bronchiolitis : Comparison with Milliman and Robertson guidelines. / Kini, Narendra M.; Robbins, James M.; Kirschbaum, Mark S.; Frisbee, Stephanie J.; Kotagal, Uma R.

In: Archives of Pediatrics and Adolescent Medicine, Vol. 155, No. 12, 2001, p. 1323-1327.

Research output: Contribution to journalArticle

Kini, NM, Robbins, JM, Kirschbaum, MS, Frisbee, SJ & Kotagal, UR 2001, 'Inpatient care for uncomplicated bronchiolitis: Comparison with Milliman and Robertson guidelines', Archives of Pediatrics and Adolescent Medicine, vol. 155, no. 12, pp. 1323-1327.
Kini, Narendra M. ; Robbins, James M. ; Kirschbaum, Mark S. ; Frisbee, Stephanie J. ; Kotagal, Uma R. / Inpatient care for uncomplicated bronchiolitis : Comparison with Milliman and Robertson guidelines. In: Archives of Pediatrics and Adolescent Medicine. 2001 ; Vol. 155, No. 12. pp. 1323-1327.
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