CoChat
Sign Up
Cited by 167Neonatal and Maternal InfectionsAntibiotic Use and ResistancePediatric Urology and Nephrology Studies

The DOI matches its Crossref record; 58 of the 58 references it cites were found in a registry or an index.

Costs and Infant Outcomes After Implementation of a Care Process Model for Febrile Infants

Open access
Byington, Carrie L., Reynolds, Carolyn C., Korgenski, Kent, Sheng, Xiaoming, Valentine, Karen J., Nelson, Richard E., Daly, Judy A., Osguthorpe, Russell J., James, Brent, Savitz, Lucy, Pavia, Andrew T., Clark, Edward B.·2012·Pediatrics
DOI 10.1542/peds.2012-0127PMC PMC4074609
Open this paper in CoChat — free account

Abstract

OBJECTIVE: Febrile infants in the first 90 days may have life-threatening serious bacterial infection (SBI). Well-appearing febrile infants with SBI cannot be distinguished from those without by examination alone. Variation in care resulting in both undertreatment and overtreatment is common. METHODS: We developed and implemented an evidence-based care process model (EB-CPM) for the management of well-appearing febrile infants in the Intermountain Healthcare System. We report an observational study describing changes in (1) care delivery, (2) outcomes of febrile infants, and (3) costs before and after implementation of the EB-CPM in a children’s hospital and in regional medical centers. RESULTS: From 2004 through 2009, 8044 infants had 8431 febrile episodes, resulting in medical evaluation. After implementation of the EB-CPM in 2008, infants in all facilities were more likely to receive evidence-based care including appropriate diagnostic testing, determination of risk for SBI, antibiotic selection, decreased antibiotic duration, and shorter hospital stays (P < .001 for all). In addition, more infants had a definitive diagnosis of urinary tract infection or viral illness (P < .001 for both). Infant outcomes improved with more admitted infants positive for SBI (P = .011), and infants at low risk for SBI were more often managed without antibiotics (P < .001). Although hospital admissions were shortened by 27%, there were no cases of missed SBI. Health Care costs were also reduced, with the mean cost per admitted infant decreasing from $7178 in 2007 to $5979 in 2009 (−17%, P < .001). CONCLUSIONS: The EB-CPM increased evidence-based care in all facilities. Infant outcomes improved and costs were reduced, substantially improving value.

Overview

Integrity signals

Registry

Crossref · 10.1542/peds.2012-0127

Cites

58 of 58 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Verification

Claims the paper makes

We couldn’t retrieve this paper’s full text, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Citations

Cites

Research works printed but not linked: 1

  1. Gesteland, 2007, A Method for Identifying Febrile Infants Presenting to the Emergency Department Using Administrative Data

Cited by

Sorted by citations

See all 167

Related

See all

Metadata

Authors
Byington, C. L., Reynolds, C. C., Korgenski, K., Sheng, X., Valentine, K. J., Nelson, R. E., Daly, J. A., Osguthorpe, R. J., James, B., Savitz, L., Pavia, A. T., & Clark, E. B.
Affiliations
  • University of Utah (US)
  • Intermountain Healthcare (US)
ORCID
Venue
Pediatrics
Publisher
American Academy of Pediatrics (AAP)
Published
2012-07-01
Volume
130
Issue
1
Pages
e16-e24
ISSN
  • 0031-4005 (ISSN-L)
  • 1098-4275
DOI
10.1542/peds.2012-0127
PMC
PMC4074609
OpenAlex
W2007863289
Cited by
167
References
58
Citations by year
2026: 3 · 2025: 4 · 2024: 10 · 2023: 6 · 2022: 11 · 2021: 13 · 2020: 10 · 2019: 18 · 2018: 25 · 2017: 17 · 2016: 11 · 2015: 16 · 2014: 8 · 2013: 13 · 2012: 2
FWCI
12.04
Type
journal article
Language
en
Open access
Locations
  • PEDIATRICS (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (5k24hd047249-05)
  • Agency for Healthcare Research and Quality (R18HS018034)
  • National Cancer Institute (KM1CA156723)
  • National Institute of Child Health and Human Development (K24HD047249, R18HS018034)
  • National Center for Research Resources (UL1RR025764, R18HS018034)
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (K24- HD047249)
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Neonatal and Maternal Infections
  • Health Sciences › Medicine › Infectious Diseases › Antibiotic Use and Resistance
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Urology and Nephrology Studies
Keywords
febrile infants, serious bacterial infection, evidence-based care, health care costs, antibiotic stewardship, length of hospital stay, diagnostic testing, urinary tract infection, viral illness, quality improvement
MeSH terms
Anti-Bacterial Agents, Clinical Protocols, Cost-Benefit Analysis, Female, Fever, Humans, Infant, Infant Care, Infant, Newborn, Length of Stay, Male, Outcome and Process Assessment, Health Care, Urinary Tract Infections, Utah, Virus Diseases, Cohort Studies, Program Evaluation, Linear Models, Logistic Models, Bacteremia, Meningitis, Bacterial, Hospital Costs, Quality Improvement

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review