NurseWeek

Hospital stays for children longer than guidelines suggest

Reuters Health
September 25, 2000


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New York. Nearly two-thirds of children who are hospitalized end up staying longer than a set of 1998 guidelines recommend, a new analysis suggests.

The results of the study cast doubt on the guidelines, which are used by a number of major managed care organizations to determine how long to keep children in the hospital, according to the HCIA-Sachs Institute, a group that provides information to the health care industry.

The guidelines were developed by the actuarial and consulting firm of Milliman & Robertson for the treatment of 45 pediatric conditions. According to HCIA-Sachs, even the most efficient, best-managed hospitals in the country have longer hospital stays than are recommended by Milliman.

Nearly two-thirds of children who did not suffer from complications of their illness stayed in the hospital longer than Milliman’s goals suggest.

Milliman recommends using the guidelines only for uncomplicated cases, HCIA-Sachs noted. But the guidelines call for shorter stays for some diseases for which as many as 85 percent of children admitted to hospitals have complications, explained Jean Chenoweth, executive director of the HCIA-Sachs Institute.

"The use of Milliman & Robertson’s pediatric guidelines could create a huge potential for putting the sickest children at risk unnecessarily," Chenoweth said in a statement announcing the findings.

The studies were conducted using 1998 data from HCIA-Sachs’ inpatient database, containing more than 3.5 million pediatric discharges.

At press time, Milliman spokesman Lloyd Robinson was unavailable for comment. In the past, the Seattle-based firm has vigorously defended its recommendations, noting that the lengths of stay are merely guidelines, not mandates.