When it comes to treating kids for acute gastroenteritis - an infection of the stomach - many children's hospitals in the U.S. are ignoring evidence-based guidelines - and costing the health care system more than $1 billion in unnecessary spending, according to the authors of a new study.

Evidence-based guidelines issued by the American Academy of Pediatrics and the Centers for Disease Control and Prevention recommend giving children lots of fluids to drink and discourage routine lab tests, Dr. Joel S. Tieder, from the University of Washington, Seattle, and colleagues note in their report. However, doctors at many hospitals give additional medications and order tests that are not recommended.

Tieder's team studied data from almost 189,000 children between 6 months and 6 years who were treated in the emergency departments of 27 children's hospitals in the US between 2001 and 2006. About 14,000 of those kids ended up being admitted to the hospital, according to the report in the journal Pediatrics.

About two-thirds - 69 percent - of the children were treated according to guidelines. In particular, the remaining children were likely to have lab tests that weren't recommended.

Tieder and colleagues found that it cost an average of $863 to treat children admitted to the hospital, compared to $591 for those who weren't admitted. When admitted patients were treated according to guidelines, the average cost was $296 lower than when guidelines were ignored.

According to the investigators, if most hospitals treated children according to guidelines, only about half as many of children would be admitted to the hospital, and the health care system would save more than $1 billion.

Despite this proven benefit to the patient and the health care community, poor adherence to the standard of care persists, Tieder and colleagues note.

SOURCE: Pediatrics, 2009.

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