Health care expenditures make up a large and increasing proportion of the US gross domestic product. Pediatrics is not immune to the problem, because expenditures on child health services are now equivalent to half of the US defense budget. Trends in our most common pediatric inpatient diagnoses, such as bronchiolitis, provide insight into the problem. Despite an apparent decrease in hospitalizations for bronchiolitis, overall costs continue to rise.

In this month’s issue of Pediatrics, Pelletier et al provide further information on the phenomenon of rising resource use for bronchiolitis. These investigators demonstrated a dramatic increase in ICU use for bronchiolitis over 10 years, without clear evidence for an increase in severity of the illness itself. Indeed, there is some evidence to the contrary, with stable to declining length of stay and frequency of invasive ventilation. In the last year of the study, 2019, nearly a quarter...

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