National survey of pediatric services available in US emergency departments
National survey of pediatric services available in US emergency departments
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DOI：
10.1186/1865-1380-6-13
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发表时间：
2013-01-01
影响因子：
3.2
通讯作者：
Camargo, Carlos A., Jr.
中科院分区：
文献类型：
--
作者：
Sullivan, Ashley F.;Rudders, Susan A.;Camargo, Carlos A., Jr.
背景：儿童占美国急诊科 (ED) 就诊人数的近 20%，但之前的全国调查发现，许多急诊科缺乏专门的儿科护理。作为回应，2001 年的联合政策声明建议急诊科提供有效的儿科急诊护理所需的资源。我们试图更新和增强之前对美国急诊室可用儿科服务的估计。方法：我们对 2007 年美国国家急诊科库存中的所有美国急诊室的 5% 随机样本 (n = 279) 进行了电话调查。该调查收集了有关当地能力（包括三种临床情况的典型管理）和儿科紧急护理协调员的流行率的数据。我们使用描述性统计来总结数据。使用多变量逻辑回归来检查调查受访者与急诊室特征以及儿科急诊医学协调员之间的关联。结果：数据收集自 238 家医院（85% 的答复率）。少数医院设有儿科（36%）或重症监护病房（12%）。儿童每年就诊急诊的人数中位数为 3,870 人次（四分位数范围 1,500-8,800 人次）。百分之十的医院设有单独的儿科急诊室；只有 17% 有指定的儿科紧急护理协调员。协调员的显着阳性预测因素是每小时 1 名患者的 ED 儿科就诊量和城市位置。大多数急诊室仅治疗轻度至中度的儿童细支气管炎和哮喘恶化病例（分别为 77% 和 65%）。不到一半 (48%) 的医院报告有能力对患有急性阑尾炎的儿童进行手术治疗。 结论：与之前的估计相比，我们发现儿科急诊服务几乎没有变化。我们的研究结果表明，需要继续进行改进，以确保儿童获得紧急护理。
Background: Children account for nearly 20% of all US emergency department (ED) visits, yet previous national surveys found that many EDs lack specialized pediatric care. In response, a 2001 joint policy statement recommended resources needed by EDs for effective pediatric emergency care delivery. We sought to update and enhance previous estimates of pediatric services available in US EDs.Methods: We administered a telephone survey to a 5% random sample (n = 279) of all US EDs from the 2007 National Emergency Department Inventory-USA. The survey collected data on local capabilities (including typical management of three clinical scenarios) and prevalence of a coordinator for pediatric emergency care. We used descriptive statistics to summarize data. Multivariable logistic regression was used to examine the association between survey respondent and ED characteristics as well as the presence of a coordinator for pediatric emergency medicine.Results: Data were collected from 238 hospitals (85% response rate). A minority of hospitals had pediatric departments (36%) or intensive care units (12%). The median annual number of ED visits by children was 3,870 (interquartile range 1,500-8,800). Ten percent of hospitals had a separate pediatric ED; only 17% had a designated pediatric emergency care coordinator. Significant positive predictors of a coordinator were an ED pediatric visit volume of = 1 patient per hour and urban location. Most EDs treated only mild-to-moderate cases of childhood bronchiolitis and asthma exacerbation (77% and 65%, respectively). Less than half (48%) of the hospitals reported the ability to surgically manage a child with acute appendicitis.Conclusion: We found little change in pediatric emergency services compared to earlier estimates. Our study results suggest a continued need for improvements to ensure access to emergency care for children.