US Emergency Department Use by Children, 2001-2010
US Emergency Department Use by Children, 2001-2010
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DOI：
10.1097/pec.0000000000000204
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发表时间：
2014-09-01
影响因子：
1.4
通讯作者：
Pines, Jesse M.
中科院分区：
文献类型：
--
作者：
Rasooly, Irit R.;Mullins, Peter M.;Pines, Jesse M.
目的儿童经常使用急诊科（EDs）来满足各种医疗保健需求。我们描述了儿童使用美国ED的最新趋势。方法：本研究是对2001年至2010年间全国医院门诊医疗调查和美国人口普查数据的横断面分析，该调查是一个具有全国代表性的急诊就诊样本。我们检查了19岁以下患者的人口统计趋势、就诊特征、保险状况、处置、医院变量、诊断、就诊原因和资源使用情况。采用线性回归评价趋势的显著性。结果约四分之一的急诊科就诊患者年龄小于19岁。2001年至2010年间，儿童急诊室就诊人数增加了14.4% (P = 0.04)；访问率从每100人36.4次增加到40.6次。创伤是儿科急诊科就诊最常见的原因。黑人儿童的ED使用率最高（2010年为61.9 / 100）。西班牙裔儿童的访诊率相对较低，但自2001年以来增加了82.7% （P = 0.00）。医疗补助受益人的急诊科就诊比例从32.0%上升到51.9% （P = 0.00）。诊断检测、静脉输液、药物治疗和出院处方的数量和频率都有所增加。接受电脑断层扫描或核磁共振成像的人次由2001年的3.1%增至2010年的6.6% (P = 0.00)，几乎翻了一番。结论儿童ED使用的增长速度快于人口增长速度，ED护理强度急剧上升。西班牙裔儿童和医疗补助受益人是使用ED的儿童中增长最快的群体。
Objective Children commonly use emergency departments (EDs) for a variety of health care needs. We describe recent trends in US ED use by children.Methods This is a cross-sectional analysis of the National Hospital Ambulatory Medical Care Survey, a nationally representative sample of ED visits, and US Census data between 2001 and 2010. We examined demographic trends, visit characteristics, insurance status, disposition, hospital variables, diagnoses, reason for visit, and resource use among patients younger than 19 years. Linear regression was used to evaluate significance of trends.Results Approximately one quarter of all ED visits was made by patients younger than 19 years. Emergency department visits by children increased 14.4% between 2001 and 2010 (P = 0.04); the rate of visits increased from 36.4 to 40.6 per 100 population. Trauma is the most common reason for pediatric ED visits. Black children had the highest rate of ED use (61.9 per 100 in 2010). Visit rates by Hispanic children were relatively low but increased by 82.7% since 2001 (P = 0.00). The proportion of ED visits by Medicaid beneficiaries rose from 32.0% to 51.9% (P = 0.00). The volume and frequency of diagnostic testing, administration of intravenous fluids, medication administration, and discharge prescriptions increased. Visits with computed tomography or magnetic resonance imaging almost doubled from 3.1% of the visits in 2001 to 6.6% of the visits in 2010 (P = 0.00).Conclusions The use of ED by children is growing faster than population growth, and the intensity of ED care has risen sharply. Hispanic children and Medicaid beneficiaries represent the fastest growing populations of children using the ED.