A review of pediatric inpatient care.

Between 101 and 188 medical records of children hospitalized in each of three community hospitals and one major teaching hospital were examined to determine need for admission and quality of care administered. Two of the hospitals had been similarily studied two years before. Twenty-five percent of all admissions and 17% of all patient days were considered unnecessary. The smallest number of inappropriate admissions was found in the major teaching institution, but one of the community hospitals without any teaching affiliation was notably better than the other two. The teaching hospital and the same community hospital also achieved the lowest questionable management rates. Significant (P less than 0.5) but minimal reduction had occurred in number of unnecessary admissions when first and second utilization studies in these two hospitals were compared.