Opportunities for Restructuring Hospital Transfer Networks for Pediatric Asthma.
To describe the current system of pediatric asthma care and identify potential options for unloading tertiary centers. Retrospective, cross-sectional study using 2014 inpatient and emergency department all-encounter administrative datasets from Arkansas, Florida, Kentucky, Maryland, Massachusetts, a...
| Publicado en: | Academic Pediatrics Vol. 22; no. 1; pp. 29 - 37 |
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| Autores principales: | , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Elsevier B.V.
Jan2022
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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=154215810&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 154215810 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 18762859 8NBK jtl: Academic Pediatrics issn: 18762859 maglogo: N pubinfo: dt: Jan2022 vid: 22 iid: 1 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 154215810 154215810 154215810 10.1016/j.acap.2021.04.013 154215810 ppf: 29 ppct: 8 formats: fmt: @attributes: type: P tig: atl: Opportunities for Restructuring Hospital Transfer Networks for Pediatric Asthma. aug: au: Brown, Lauren França, Urbano L. McManus, Michael L. affil: Department of Anesthesiology, Critical Care and Pain Medicine, Division of Critical Care, Boston Children's Hospital, Harvard Medical School, Boston, Mass sug: subj: Pediatric Care Asthma Hospital Restructuring Transfer, Discharge Evaluation Human Retrospective Design Cross Sectional Studies Data Management Patient Admission Economics Length of Stay Funding Source Hospitals, Community ab: To describe the current system of pediatric asthma care and identify potential options for unloading tertiary centers. Retrospective, cross-sectional study using 2014 inpatient and emergency department all-encounter administrative datasets from Arkansas, Florida, Kentucky, Maryland, Massachusetts, and New York. Study participants included children <18 with primary diagnosis of asthma. There were 174,239 encounters for pediatric asthma, with 26,316 admissions and 3101 transfers. About 94.4% of transfers were admitted, with median stay length 2 days (interquartile range [IQR] 1.0–3.0). About 637 hospitals saw pediatric asthma, but 58.7% never admitted these patients. Fifty-four hospitals (8.5%) regularly received transfers; these hospitals were broadly capable pediatric centers (mean pediatric hospital capability indices = 0.82, IQR: 0.64–0.89). Two hundred nine facilities (32.8%) did not regularly receive transfers but were highly capable of caring for pediatric asthma (mean condition-specific capability = 0.92, IQR: 0.85–1.00). Median distance from transferring hospitals to the nearest pediatric center was 25.7 miles (IQR: 6.45–50.15) vs 18.0 miles (IQR: 8.35–29.25) to the nearest potential receiving hospital. Mean cost of a 2-day asthma admission in receiving hospitals was $3927 (IQR: $3083–$4894) versus $3427 (IQR: $2485–$4102) in potential receivers. While nearly all acute care hospitals encounter children with asthma, more than half never admit them. Children are primarily transferred to a small subset of specialized centers, despite the existence, in many regions, of closer community hospitals with high pediatric asthma capability. In settings with long transfer distances and tertiary center crowding, a tiered system of hospital care for pediatric asthma may be feasible. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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