Pediatric Out-of-hospital Emergency Medical Services Utilization in Kansas City, Missouri
Pediatric Out-of-hospital Emergency Medical Services Utilization in Kansas City, Missouri
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DOI：
10.1111/j.1553-2712.2009.00418.x
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发表时间：
2009-06-01
影响因子：
4.4
通讯作者：
Simon, Stephen D.
中科院分区：
文献类型：
--
作者：
Miller, Melissa K.;Dowd, Denise;Simon, Stephen D.
目的是描述密苏里州堪萨斯城儿科紧急医疗服务（EMS）运输的流行病学特征和使用模式。该研究包括对2002年1月1日至2004年12月31日密苏里州堪萨斯城15岁以下居民（不包括设施间运输）的运输进行回顾性分析。数据包括人口统计、保险、运输日期和时间、患者邮政编码、主诉和个人运输次数。比率是用人口普查间的估计来计算的。所有费率均以每年每1 000人的运输次数表示。在3年的研究期间，总共发生了5,717例儿科转运。所有用户的传输速率为18 PPY，小于1岁的为42 PPY， 1-4岁的为23 PPY， 5-9岁的为12 PPY， 10-14岁的为14 PPY。小于1岁的婴儿比5-9岁的儿童更有可能使用EMS（相对危险度[RR] = 3.7, 95%可信区间[CI] = 3.4 ~ 4.0）。男性比女性更有可能使用EMS （RR = 1.2, 95% CI = 1.1 ~ 1.3）。大多数人（64%）享受医疗补助。运输量在下午4点到8点之间达到峰值，最低使用量在凌晨4点到8点之间（p < 0.001）。总体使用量没有因工作日或季节而变化。呼吸转运在秋季和冬季多见，而创伤转运在夏季多见（p < 0.001）。最常见的诊断是创伤（27%）、神经系统（19%）和呼吸系统（18%）。11%的用户不止一次访问EMS（占所有传输的26%）。交通运输率与邮政编码家庭收入中位数之间存在显著的逆线性关系（r = -0.36, p < 0.001）。邮政编码中收入较低的儿童、婴儿和男性更有可能使用EMS。与这些增加的运输率有关的因素尚不清楚。学术急诊医学2009；16:526-531 (C) 2009年由学术急诊医学学会出版。
The objective was to describe epidemiologic features and usage patterns of pediatric emergency medical services (EMS) transports in Kansas City, Missouri.The study consisted of a retrospective analysis of transports from January 1, 2002, to December 31, 2004, for Kansas City, Missouri, residents younger than 15 years of age (excluding interfacility transports. Data included demographics, insurance, day and time of transport, patient zip code, chief complaint, and number of individual transports. Rates were calculated using intercensal estimates for the denominator. All rates were expressed as number of transports per 1,000 persons per year (PPY).A total of 5,717 pediatric transports occurred in the 3-year study period. Transport rates were 18 PPY for all users, 42 PPY for those < 1 year old, 23 PPY for ages 1-4 years, 12 PPY for ages 5-9 years, and 14 PPY for ages 10-14 years. Infants < 1 year were more likely than children aged 5-9 years to use EMS (relative risk [RR] = 3.7, 95% confidence interval [CI] = 3.4 to 4.0). Males were more likely than females to use EMS (RR = 1.2, 95% CI = 1.1 to 1.3). Most (64%) were insured by Medicaid. Transports peaked between 4 pm and 8 pm, and lowest usage was 4 am to 8 am (p < 0.001). Overall usage did not vary by weekday or season. Respiratory transports were more common in the fall and winter, while trauma transports were more common in the summer (p < 0.001). The most common diagnoses were trauma (27%), neurologic (19%), and respiratory (18%). Eleven percent of users accessed EMS more than once (26% of all transports). There was a significant inverse linear relationship between transport rate and median family income by zip code (r = -0.36, p < 0.001).Children in zip codes with lower incomes, infants, and males were more likely to use EMS. Factors related to these increased transport rates are unknown.ACADEMIC EMERGENCY MEDICINE 2009; 16:526-531 (C) 2009 by the Society for Academic Emergency Medicine.