National profile of nonemergent pediatric emergency department visits.
OBJECTIVE: Emergency department (ED) crowding prevents the efficient and effective use of health services and compromises quality. Patients who use the ED for nonemergent health concerns may unnecessarily crowd ED services. In this article we describe characteristics of pediatric patients in the Uni...
| Publicado en: | Pediatrics Vol. 125; no. 3; pp. 454 - 460 |
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| Autores principales: | , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
American Academy of Pediatrics
Mar2010
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105133821&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105133821 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00314005 PDT jtl: Pediatrics issn: 00314005 maglogo: N pubinfo: dt: Mar2010 vid: 125 iid: 3 pid: 1659 pub: American Academy of Pediatrics place: Elk Grove Village, Illinois artinfo: ui: 105133821 2010581298 10.1542/peds.2009-0544 NLM20123777 105133821 ppf: 454 ppct: 6 formats: tig: atl: National profile of nonemergent pediatric emergency department visits. aug: au: Ben-Isaac E Schrager SM Keefer M Chen AY affil: Childrens Hospital Los Angeles, 4650 Sunset Blvd, Mail Stop 30, Los Angeles, CA 90027; achen@chla.usc.edu. sug: subj: Emergency Service Utilization Health Care Costs Pediatric Care Adolescence Bivariate Statistics Child Child, Preschool Conceptual Framework Data Analysis Software Female Funding Source Human Infant Infant, Newborn Logistic Regression Male Questionnaires United States Univariate Statistics Adolescent: 13-18 years Child: 6-12 years Child, Preschool: 2-5 years Infant: 1-23 months Infant, Newborn: birth-1 month Female Male ab: OBJECTIVE: Emergency department (ED) crowding prevents the efficient and effective use of health services and compromises quality. Patients who use the ED for nonemergent health concerns may unnecessarily crowd ED services. In this article we describe characteristics of pediatric patients in the United States who use EDs for nonemergent visits. METHODS: We analyzed data from the 2002-2005 Medical Expenditure Panel Survey. The Medical Expenditure Panel Survey is conducted by the Agency for Healthcare Research and Quality and consists of a nationally representative sample of the civilian noninstitutionalized population of the United States. Our study sample consisted of 5512 person-years of observation. We included only ED visits for children from birth to 17 years of age with a specified International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code. The main dependent variable for our multivariate logistic model was nonemergent ED use, which was constructed by using the New York University ED-classification algorithm. Independent variables were derived from Andersen's Behavioral Model of Health Services Utilization. RESULTS: We found that from 2002 to 2005, a nationally representative sample of US children from birth to 17 years of age used EDs for various nonemergent or primary care-treatable diagnoses. Overall, children from higher-income families had higher ED expenditures than children from lower-income families. Children with private insurance had higher total ED expenditures than publicly insured or uninsured children, but uninsured children had the highest out-of-pocket expenditures. We found that children from birth to 2 years of age were less likely to use the ED for nonemergent diagnoses (odds ratio [OR]: 0.13; P < .01) compared with older children. Non-Hispanic black children were also less likely to use the ED for nonemergent diagnoses (OR: 0.40; P = .03) than were non-Hispanic white children. CONCLUSION: Children's sociodemographic characteristics were predictors of nonemergent use of ED services. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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