Pediatric Hospital Admission and Role of Clinical Practice Guidelines

To the Editor I read with great interest the article by Kaiser et al describing pediatric hospitalization patterns in different hospital setups. In the data presented from 3768 US hospitals (Figure 1), an estimate of 34 704 of 1 777 023 nonbirth pediatric hospitalizations (1.95%) occurred because of neonatal hyperbilirubinemia (NHB). The prevalence rankings of NHB differed among hospitals (ranking 5 in urban nonteaching hospitals and rural hospitals, 7 in urban teaching hospitals, and 20 in freestanding children’s hospitals). On further analysis, NHB constituted 2.42 admissions (3447/1424) per rural hospital, 6.18 (7148/1156) per urban nonteaching hospital, 16.90 (18 844/1115) per urban teaching hospital, and 72.15 (5267/73) per freestanding children’s hospital. It was interesting to note that NHB was ranked 20th in freestanding hospitals but the rate of admissions per hospital was high compared with other hospital types.