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Admission-Day Crowding May Increase Hospital Stay for Children With Less Complicated Illnesses

PHILADELPHIA, April 9, 2008 /PRNewswire-USNewswire/ -- When a hospital is crowded on admission day, children may be in for a longer hospital stay if they have less complicated illnesses that require ongoing assessment of their condition, such as respiratory disease. Hospital crowding does not affect the length of stay for children with the most serious, complicated conditions, such as sickle cell crises or bacterial meningitis.

"Our findings suggest that during a period of increased workload, hospital caregivers first focus their attention on the complicated, more acutely ill children, and thus delay treatment of less complicated children whose care still requires complex management and treatment," said lead author Scott Lorch, M.D. M.S.C.E., a neonatologist at The Children's Hospital of Philadelphia and lead author of the study.

Respiratory conditions are the most common reasons for pediatric hospitalization. While they tend to be less severe than other conditions, children with these conditions require time-consuming, ongoing assessment of both their respiratory status and their ability to wean from therapies such as supplemental oxygen and nebulizer treatments. Their care also involves multiple health care providers such as nurses, respiratory therapists and physicians throughout their hospital stay.

The researchers looked at all the children admitted to 323 hospitals in Pennsylvania and New York. The 116,000 children were between the ages of one and 17 years and were diagnosed with one of 19 common pediatric conditions between April 1996 and June 1998. The study appears in the April issue of the journal Pediatrics.

Overall, more that 20 percent of children in this study were admitted when the hospital occupancy rate was approximately 90 percent; and 11 percent of children were admitted when the occupancy rate was at 100 percent. During the time of this study, the median hospital occupancy rate was 75 percent.

For children admitted with respiratory disease (including viral and bacterial pneumonia, asthma and croup or bronchitis), admission day occupancy above 60 percent resulted in a 25 day increase in the average length of stay per 100 patients. For children who were admitted with non-respiratory conditions, increased admission-day occupancy was not associated with length of stay.

"Our study suggests that the increase in length of stay primarily affects less complicated children who require complex management and treatment, not children affected with high-severity conditions," said Lorch.

Lorch's coauthors were Andrea M. Millman, B.A.; Xuemei Zhang, M.S.; Orit Even-Shoshan, M.S. and Jeffrey H. Silber, M.D., Ph.D. all of The Children's Hospital of Philadelphia.

About The Children's Hospital of Philadelphia: The Children's Hospital of Philadelphia was founded in 1855 as the nation's first pediatric hospital. Through its long-standing commitment to providing exceptional patient care, training new generations of pediatric healthcare professionals and pioneering major research initiatives, Children's Hospital has fostered many discoveries that have benefited children worldwide. Its pediatric research program is among the largest in the country, ranking third in National Institutes of Health funding. In addition, its unique family-centered care and public service programs have brought the 430-bed hospital recognition as a leading advocate for children and adolescents. For more information, visit

CONTACT: Joey Marie McCool

Phone: (267)426-6070

SOURCE The Children's Hospital of Philadelphia
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