Mills David, Segura Bradley, Zaremba Jen, Louie Jeffrey P
From the Department of Pediatrics and Divisions of.
Pediatric Surgery.
Pediatr Emerg Care. 2019 Apr;35(4):283-285. doi: 10.1097/PEC.0000000000001799.
Transition of pediatrics services to freestanding children's hospitals is a common trend over the past 3 decades, yet there is no published information on the effect of these moves on the pediatric emergency department (ED). We looked at the effect on trauma volume and severity presenting to the ED after transitioning to a freestanding children's hospital at a location previously without dedicated pediatrics services.
We analyzed data using a retrospective chart review of pediatric trauma visits (age, <15 years) from our pediatric trauma registry. Data analyzed included trauma volume per year, injury severity score, method of trauma, and method of arrival to hospital. Patients were differentiated into groups based on premove years (2008-2010) and postmove years (2012-2014).
A total of 833 trauma patients were admitted to the ED between 2008 and 2014. Trauma volume per year almost doubled in years after the move. Difference in injury severity score and methods of trauma were not statistically significant. In postmove years, there was an increase in emergency medical service and private vehicle visits.
New characteristics and location of the freestanding children's hospital may suggest that easy access to the new location, parental preferences for specialized pediatrics services, and emergency medical service preferences may have positively impacted trauma volume without affecting the severity of trauma seen in our department. This study provides a unique single-center experience in understanding ED patient flow after a major department transition.
在过去三十年中，儿科服务向独立儿童医院的转变是一种普遍趋势，但关于这些转变对儿科急诊科（ED）影响的公开信息却很少。我们研究了在一个先前没有专门儿科服务的地点转变为独立儿童医院后，对急诊科收治的创伤病例数量和严重程度的影响。
我们通过回顾性图表审查，分析了来自儿科创伤登记处的儿科创伤就诊（年龄<15岁）数据。分析的数据包括每年的创伤病例数量、损伤严重程度评分、创伤方式以及到达医院的方式。患者根据搬迁前年份（2008 - 2010年）和搬迁后年份（2012 - 2014年）进行分组。
2008年至2014年间，共有833名创伤患者被收治到急诊科。搬迁后每年的创伤病例数量几乎翻了一番。损伤严重程度评分和创伤方式的差异无统计学意义。在搬迁后年份，急诊医疗服务和私家车就诊有所增加。
独立儿童医院的新特点和位置可能表明，新地点的便捷可达性、家长对专科儿科服务的偏好以及急诊医疗服务偏好可能对创伤病例数量产生了积极影响，而未影响我们科室所见创伤的严重程度。本研究为理解主要科室转变后的急诊科患者流量提供了独特的单中心经验。
