Interhospital variation of inpatient versus outpatient pediatric burn treatment after emergency department evaluation.
Interhospital variation of inpatient versus outpatient pediatric burn treatment after emergency department evaluation.
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DOI：
10.1016/j.jpedsurg.2020.03.018
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发表时间：
2020-10
影响因子：
2.4
通讯作者：
Cina RA
中科院分区：
文献类型：
--
作者：
Garcia DI;Lesher AP;Corrigan C;Howard HR;Cina RA
儿科人群的烧伤护理方法差异很大，可以作为降低成本的潜在措施。我们假设，机构在非严重烧伤的治疗分配到住院或门诊治疗方面存在显着差异。我们查询了2017财年的PHIS数据库，以量化小儿小烧伤入院和急诊科就诊（艾德）。ICD-10代码T31.0用于识别烧伤面积≤10%的体表总面积（TBSA）。中心按烧伤中心状态分类，并比较住院时间、再入院率和费用。在纳入的儿科儿童医院中，住院与门诊管理分布存在显著差异（n=34，p<0.00001）。当分析门诊护理数据时，双峰分布区分为两组：平均30%门诊烧伤护理的高医院利用率和平均87%的低利用率。与艾德烧伤治疗相比，每位患者的平均住院费用超过31倍（p<0.0001）。住院与门诊小儿烧伤管理的变异性小烧伤是显着的。与门诊烧伤护理相比，住院护理的费用明显更高。实施协议和人员，以提供足够的关注，小烧伤的艾德可能是一个重要的成本节约措施。
Approaches to burn care in the pediatric population are highly variable and can be targeted as a potential measure in cost-reduction. We hypothesized that institutions vary significantly in treatment allocation of non-severe burns to either inpatient or outpatient care. We queried the PHIS database for fiscal year 2017 to quantify small pediatric burn admissions and Emergency Department visits(ED). The ICD-10 code T31.0 was used to identify burns involving ≤10% of total body surface area (TBSA). Centers were categorized by burn center status and length of stay, readmissions, and charges were compared. Inpatient versus outpatient management distribution was significantly different across the included pediatric children’s hospitals (n=34, p<0.00001). When data was analyzed with respect to outpatient care, a bimodal distribution distinguished two groups: high hospital-utilizers with an average of 30% outpatient burn care and low-utilizers averaging 87%. Median inpatient charge per patient was greater than 31-fold compared to ED burn management (p<0.0001). Variability of inpatient versus outpatient pediatric burn management in small burns was significant. Compared to outpatient burn care, inpatient care is significantly more costly. Implementing protocols and personnel to provide adequate attention to small burns in the ED could be an important cost-saving measure.
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DOI：
10.1097/bcr.0000000000000274
发表时间：
2016-01
期刊：
Journal of burn care & research : official publication of the American Burn Association
影响因子：
--
作者：
Hodgman EI;Saeman MR;Subramanian M;Wolf SE
通讯作者：
Wolf SE
影响因子：
3.1
作者：
Warner, Petra M.;Coffee, Tammy L.;Yowler, Charles J.
通讯作者：
Yowler, Charles J.
DOI：
10.1097/pcc.0b013e318238b428
发表时间：
2012-07
期刊：
Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
影响因子：
--
作者：
Bratton SL;Newth CJ;Zuppa AF;Moler FW;Meert KL;Berg RA;Berger J;Wessel D;Pollack M;Harrison R;Carcillo JA;Shanley TP;Liu T;Holubkov R;Dean JM;Nicholson CE;Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network
通讯作者：
Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network
影响因子：
3.8
作者：
Anderson, Kathryn Tinsley;Bartz-Kurycki, Marisa A.;Tsao, KuoJen
通讯作者：
Tsao, KuoJen
影响因子：
9
作者：
Cameron, Danielle B.;Serres, Stephanie K.;Rangel, Shawn J.
通讯作者：
Rangel, Shawn J.