High Variability in Admission Decisions for Patients with Pneumonia

Admission rates by individual physicians at a single emergency department varied twofold, and variations were not explained by patient, disease, or physician factors.

To assess variability among physicians in their decisions to admit patients with community-acquired pneumonia (CAP), researchers conducted a retrospective chart review of 2069 adult patients with diagnoses of CAP who presented to a single emergency department in Salt Lake City during an 11-year period. The decision to admit was adjusted for patient demographics and disease acuity, including vital signs, laboratory and radiographic results, and outcomes. Low acuity was defined as PaO₂/FiO₂ ratio ≥280 mm Hg, predicted mortality <5% by eCURB (an electronic decision support tool), and <3 minor criteria for severe pneumonia per 2007 Infectious Diseases Society of America–American Thoracic Society guidelines.

Physicians' admission rates ranged fro…

Reviewing Author

Richard D. Zane, MD, FAAEM

Disclosures

Nothing to disclose

Richard D. Zane, MD, FAAEM

Disclosures

Nothing to disclose