Samuels-Kalow Margaret E, Sullivan Ashley F, Boggs Krislyn M, Gao Jingya, Alpern Elizabeth R, Camargo Carlos A
Department of Emergency Medicine Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA.
Division of Emergency Medicine Department of Pediatrics Ann & Robert H. Lurie Children's Hospital Northwestern University Feinberg School of Medicine Chicago Illinois USA.
J Am Coll Emerg Physicians Open. 2021 Jun 22;2(3):e12478. doi: 10.1002/emp2.12478. eCollection 2021 Jun.
Health services research on the differences in care between pediatric and general emergency departments (EDs) is limited by ambiguity regarding the definition of a pediatric ED. Our goal was to determine the proportion of EDs captured by commonly used definitions of pediatric ED.
We linked data for 2016 from two databases from New York State - the State Emergency Department Database and State Inpatient Database (SEDD/SID) and the National Emergency Department Inventory-USA (NEDI-USA). We examined the following 4 common definitions of pediatric ED: (1) admission capability, (2) physically distinct pediatric area in the ED, (3) membership in the Children's Hospital Association, and (4) volume of pediatric ED visits (patients <18 years ). We calculated the proportion of EDs that would be defined as pediatric for each criterion. We also examined the differences in patient demographics among pediatric EDs based on each criterion.
A total of 160 New York EDs were included in the linked databases. Across the 4 criteria, the proportion of EDs meeting the definition of ranged from 0% to 86%. Of the EDs, 86% had pediatric admission capability, 27%-38% had a physically distinct pediatric ED, and 8% were members of the Children's Hospital Association. No hospitals met the SEDD/SID criterion of ≥70% visits for patients <18 years.
The number of EDs and characteristics of patients seen varied widely based on the criterion used to define pediatric ED. Database linkage may make it challenging to identify pediatric hospitals in administrative data sets. A valid, standard definition of pediatric ED is critically needed to advance health services research.
儿科急诊科与普通急诊科在医疗护理方面差异的卫生服务研究，因儿科急诊科定义的模糊性而受到限制。我们的目标是确定常用儿科急诊科定义所涵盖的急诊科比例。
我们将来自纽约州两个数据库（州急诊科数据库和州住院患者数据库[SEDD/SID]以及美国国家急诊科清单[NEDI-USA]）的2016年数据进行了关联。我们研究了以下4种常见的儿科急诊科定义：（1）收治能力；（2）急诊科内物理上独立的儿科区域；（3）儿童医院协会成员；（4）儿科急诊科就诊量（年龄<18岁的患者）。我们计算了每种标准下被定义为儿科急诊科的比例。我们还根据每种标准研究了儿科急诊科患者人口统计学特征的差异。
关联数据库中总共纳入了160家纽约急诊科。在这4项标准中，符合定义的急诊科比例从0%到86%不等。在这些急诊科中，86%具备儿科收治能力，27% - 38%有物理上独立的儿科急诊科，8%是儿童医院协会成员。没有医院达到SEDD/SID中年龄<18岁患者就诊量≥70%的标准。
根据用于定义儿科急诊科的标准不同，急诊科数量和所见患者特征差异很大。数据库关联可能会使在行政数据集中识别儿科医院具有挑战性。迫切需要一个有效的儿科急诊科标准定义来推进卫生服务研究。
