Arch Pediat Adol Med
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To study the effects of an inpatient asthma clinical pathway on the processes and outcomes for children who were admitted to a hospital for the treatment of asthma. ⋯ The asthma clinical pathway had no effect on clinical outcomes and small effects on the use of resources. Further development, including physician and nurse training, computer and administrative support, and clinical severity scales, are needed to develop the potential utility of the clinical pathway as a research and quality assurance tool.
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Arch Pediat Adol Med · Jul 1997
Costs of poison-related hospitalizations at an urban teaching hospital for children.
Childhood poisonings continue to exact a notable toll in injury-related morbidity and economic cost. Because a substantial portion of this morbidity and economic cost is associated with hospitalization, an analysis of the cost of poisoning hospitalizations might help to identify areas in which medical care could be improved and costs could be reduced. ⋯ Despite an increasing number of children hospitalized for poisoning at one institution during a 4-year period, per case hospital charges decreased substantially. The cost savings were associated with a marked decrease in LOS. Still, poison-related admissions to a single pediatric facility accounted for almost $1 million in hospital charges in fiscal year 1995. A few agents are overrepresented; new poisoning prevention measures aimed at these toxic agents are warranted. We conclude that further outcomes studies are needed to delineate cost-effective improvements in patient care targeted toward poisonings owing to those agents.
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Arch Pediat Adol Med · Jul 1997
Randomized Controlled Trial Clinical TrialEfficacy of Auralgan for treating ear pain in children with acute otitis media.
To determine the efficacy of Auralgan otic solution (combination product of antipyrine, benzocaine, and glycerin) compared with an olive oil placebo in the management of moderate to severe ear pain in children with acute otitis media (AOM). ⋯ In children with AOM-associated ear pain who are treated with acetaminophen, topically applied Auralgan appears likely to provide additional relief in varying degree within 30 minutes.
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Arch Pediat Adol Med · Jun 1997
Comparative StudyDoes greater pediatric experience influence treatment choices in chronic disease management? Dialysis modality choice for children with end-stage renal disease.
To determine whether treatment choice for children with end-stage renal disease varies with greater pediatric experience at the dialysis facility. ⋯ Children receiving care at dialysis facilities that have greater experience with pediatric patients are more likely to receive peritoneal dialysis than hemodialysis, a therapy with recognized clinical benefits for children that is inherently less resource intensive than is hemodialysis.
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Arch Pediat Adol Med · Apr 1997
Comparative StudyPediatricians' experience with and attitudes toward firearms. Results of a national survey.
In 1992, the American Academy of Pediatrics issued statements calling for aggressive actions to reduce the dangers of firearms to children and adolescents, including removing handguns from homes with children and working toward a ban on the manufacture, sale, and private possession of handguns. ⋯ The data indicate that practicing pediatrician overwhelmingly agree that handguns in the home are hazardous and that steps should be taken to reduce this hazard through legislation and patient counseling. They support the policies on firearms and handguns of the American Academy of Pediatrics; most support even the strongest recommendation, which is a ban on handguns. A substantial lag between attitudes that favor counseling about firearms and reported practices indicates the need for further training in and evaluation of firearm counseling in office settings.