Pediatric Respiratory Illnesses: An Update on Achievable Benchmarks of Care

• Published in: Pediatrics (Evanston) 2023-08, Vol.152 (2), p.1
• Main Authors: Reyes, Mario A, Etinger, Veronica, Hronek, Carla, Hall, Matt, Davidson, Amber, Mangione-Smith, Rita, Kaiser, Sunitha V, Parikh, Kavita
• Format: Article
• Language: English
• Subjects: Antibiotics; Asthma; Bronchodilators; Bronchopneumonia; Coronaviruses; COVID-19; Croup; Emergency medical care; Illnesses; Pediatrics; Pneumonia; Public health; Respiratory diseases
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.2022-058389

Pediatric respiratory illnesses (PRI): asthma, bronchiolitis, pneumonia, croup, and influenza are leading causes of pediatric hospitalizations, and emergency department (ED) visits in the United States. There is a lack of standardized measures to assess the quality of hospital care delivered for these conditions. We aimed to develop a measure set for automated data extraction from administrative data sets and evaluate its performance including updated achievable benchmarks of care (ABC). A multidisciplinary subject-matter experts team selected quality measures from multiple sources. The measure set was applied to the Public Health Information System database (Children's Hospital Association, Lenexa, KS) to cohorts of ED visits and hospitalizations from 2017 to 2019. ABC for pertinent measures and performance gaps of mean values from the ABC were estimated. ABC were compared with previous reports. The measure set: PRI report includes a total of 94 quality measures. The study cohort included 984 337 episodes of care, and 82.3% were discharged from the ED. Measures with low performance included bronchodilators (19.7%) and chest x-rays (14.4%) for bronchiolitis in the ED. These indicators were (34.6%) and (29.5%) in the hospitalized cohort. In pneumonia, there was a 57.3% use of narrow spectrum antibiotics. In general, compared with previous reports, there was improvement toward optimal performance for the ABCs. The PRI report provides performance data including ABC and identifies performance gaps in the quality of care for common respiratory illnesses. Future directions include examining health inequities, and understanding and addressing the effects of the coronavirus disease 2019 pandemic on care quality.