Critically ill children brought to hospital emergency departments that are ill-prepared to care for pediatric emergencies have more than three times the odds of dying compared to those brought to hospitals well-equipped to care for them, according to an analysis led by University of Pittsburgh and University of California-Los Angeles physician-scientists.
The findings, published in the journal Pediatrics, are the first to provide evidence from multiple states linking the readiness of hospital emergency departments to care for critically ill or injured children with outcomes, and could guide a variety of policy responses.
“Pediatric care requires specialized equipment, training and protocols to provide the best care to children. Obtaining that kind of preparedness is costly and time-consuming,” said senior author Dr. Jeremy Kahn, professor in the Department of Health Policy and Management at the University of Pittsburgh Graduate School of Public Health. “Our study suggests that efforts to better prepare hospitals to care for pediatric emergencies save lives.”
Dr. Kahn and his colleagues obtained data from 426 hospitals in five states, on 20,483 critically ill patients age 18 or younger who were brought to the hospital emergency department. They cross-referenced the patient outcomes with the “pediatric readiness” of the hospital’s emergency department.
The hospitals were divided into four groups based on their pediatric readiness score, with the lowest quartile’s scores ranging from 29.6 to 59.3, and the highest from 88.2 to 99.9. Hospitals in the lowest quartile had a pediatric mortality rate for critically ill children of 11.1 percent, compared to 3.4 percent for the highest.Friday Letter Submission, Publish on September 06