Burt Catharine W, Middleton Kimberly R
Ambulatory Care Statistics Branch, Division of Health Care Statistics, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD 20782, USA.
Pediatr Emerg Care. 2007 Oct;23(10):681-9. doi: 10.1097/PEC.0b013e3181558d43.
The purpose of this analysis is to investigate hospital and community factors associated with the availability of pediatric services, expertise, and supplies in US hospitals for treating pediatric emergencies.
Data from the Emergency Pediatric Services and Equipment Supplement, a component of the 2002-2003 National Hospital Ambulatory Medical Care Survey, were merged with hospital and community characteristics to model preparedness to treat pediatric emergencies. The National Hospital Ambulatory Medical Care Survey samples nonfederal, short-stay, and general hospitals in the United States. The Emergency Pediatric Services and Equipment Supplement was based on the 2001 guidelines developed by the American Academy of Pediatrics and the American College of Emergency Physicians. Estimates were weighted to produce unbiased national estimates of pediatric services, expertise, and equipment availability in emergency departments. Logistic regression was used to model the probability of being better prepared based on the above guidelines.
Bivariate analyses showed that hospital inpatient pediatric structure was linearly related to availability of supplies. However, inpatient structure was not associated with presence of a pediatric trauma service or written transfer agreement. Logistic regressions with each preparedness measure indicated that, after adjusting for hospital and community factors, pediatric volume, teaching hospital status, geographic region, and per capita income of the community were strongly related to being better prepared on each of the preparedness measures.
To meet the 2001 guidelines, emergency departments need to improve their inventory of pediatric supplies, and hospitals that do not have specialized inpatient services need to implement written transfer agreements with other hospitals.
本分析旨在调查与美国医院治疗儿科急诊的儿科服务、专业知识及物资供应可用性相关的医院和社区因素。
将2002 - 2003年国家医院门诊医疗调查的一个组成部分——急诊儿科服务与设备补充调查的数据，与医院和社区特征相结合，以建立治疗儿科急诊的准备情况模型。国家医院门诊医疗调查对美国的非联邦、短期住院和综合医院进行抽样。急诊儿科服务与设备补充调查基于美国儿科学会和美国急诊医师学会2001年制定的指南。估计值经过加权处理，以得出急诊科儿科服务、专业知识及设备可用性的无偏全国估计值。使用逻辑回归基于上述指南对准备更充分的概率进行建模。
双变量分析表明，医院儿科住院结构与物资供应可用性呈线性相关。然而，住院结构与儿科创伤服务的存在或书面转诊协议无关。对每项准备措施进行逻辑回归分析表明，在调整医院和社区因素后，儿科患者数量、教学医院地位、地理区域以及社区人均收入与在每项准备措施上准备更充分密切相关。
为符合2001年指南，急诊科需要改善其儿科物资库存，且没有专门住院服务的医院需要与其他医院签订书面转诊协议。
