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Evaluation of Differences Between Pediatric and General Emergency Departments in Rate of Admission and Resource Utilization for Visits by Children and Young Adults with Complex Chronic Conditions

Murtagh Kurowski, Eileen, M.D.

Abstract Details

2012, MS, University of Cincinnati, Medicine: Clinical and Translational Research.
Objective: To evaluate for differences in rate of admission and charges between pediatric and general emergency departments for visits by children and young adults with complex chronic conditions Design: Cross-sectional study using data from the 2008 Nationwide Emergency Department Sample Setting: Stratified sample of U.S. hospital-based ED visits Participants: Visits by pediatric-aged patients aged 0-17 years of age and transition-aged patients aged 18-24 years of age with one or more complex chronic conditions Main exposures: Type of ED in which the visit occurred, designated as a pediatric or a general ED Main outcome measures: The three primary outcome measures were: percent of patients admitted from the ED, ED Charges for treat-and-release visits, and total charges (ED + inpatient) for admitted patients. Results: A significantly higher percentage of visits by both pediatric-aged and transition-aged patients to pediatric EDs that had multiple CCCs and technology dependence when compared to visits to general EDs (p<0.0001). When controlling for patient and hospital characteristics, the type of ED was not a significant predictor of admission, ED charges or total charges. Markers of disease severity, presence of multiple CCCs and technology dependence, were predictive of admission and total charges in both pediatric-aged and transition-aged patients. Conclusions: Overall, the results highlight that the influence of type of ED is not significant when controlling for patient and hospital characteristics. This suggests that the increased charges observed at pediatric hospitals in previous studies may be in part due to uncontrolled for differences in disease severity between the individuals cared for at pediatric and general facilities. Our analysis showed that among visits by both pediatric and transition-aged patients, there was a higher percentage of visits by patients with technology dependence and multiple CCCs at pediatric EDs compared to general EDs. This result suggests that more complex patients are more commonly cared for, both initially as young children and later as they reach and possibly surpass the age of transition, in pediatric EDs and pediatric hospitals.
Erin Nicole Haynes, Ph.D. (Committee Chair)
Jackie Grupp-Phelan, M.D., M.P.H. (Committee Member)
Terri L. Byczkowski, Ph.D., M.B.A. (Committee Member)
20 p.

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Citations

  • Murtagh Kurowski, M.D., E. (2012). Evaluation of Differences Between Pediatric and General Emergency Departments in Rate of Admission and Resource Utilization for Visits by Children and Young Adults with Complex Chronic Conditions [Master's thesis, University of Cincinnati]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1353950161

    APA Style (7th edition)

  • Murtagh Kurowski, M.D., Eileen. Evaluation of Differences Between Pediatric and General Emergency Departments in Rate of Admission and Resource Utilization for Visits by Children and Young Adults with Complex Chronic Conditions. 2012. University of Cincinnati, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=ucin1353950161.

    MLA Style (8th edition)

  • Murtagh Kurowski, M.D., Eileen. "Evaluation of Differences Between Pediatric and General Emergency Departments in Rate of Admission and Resource Utilization for Visits by Children and Young Adults with Complex Chronic Conditions." Master's thesis, University of Cincinnati, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1353950161

    Chicago Manual of Style (17th edition)