30 婴儿使用急诊室的特点

IF 2.1 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Journal of Clinical and Translational Science Pub Date : 2024-04-03 DOI:10.1017/cts.2024.47
Mary Beth Howard, Leticia M. Ryan, Oluwakemi Badaki-Makun
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The relationship between patient and visit characteristics with utilization and repeat visits was assessed using multivariable regression. RESULTS/ANTICIPATED RESULTS: A total of 20,620 patients with 33,127 ED visits during study timeframe. Thirty three percent (n=6842) had more than one visit in a year; 3964 (19.2%) had two visits, 1542 (7.5%) had three visits, and 1336 (6.5%) had 4 or more visits. Across all visits, over half (52%) were low acuity. The most common diagnoses were respiratory diseases (27%), systemic states (including fever, viral illness, 23%), and gastrointestinal diseases (15%). These diagnoses remained the most common for those with 1, 2, 3, and ≥ 4 ED visits during follow up. As ED visit frequency increased, there was an increase in percentage of children who were older, non-Hispanic Black, and triaged as low acuity. Infants with ≥ 4 ED visits were more likely to be without a chronic condition, have no medications or testing ordered, and be discharged. 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引用次数: 0

摘要

目的/目标:经常使用急诊科(ED)的患者在急诊科总就诊人数中占很大比例。在儿科急诊室(PED)中,婴儿是一个年龄组,在急诊室就诊人数中所占比例过大。我们的目的是通过就诊频率和资源利用率来比较 1 岁以下儿童使用 PED 的模式。方法/研究人群:对一个医疗系统的 5 家急诊室在 5 年内就诊的 1 岁以下婴儿进行回顾性队列研究,每次就诊后进行 365 天的随访。研究评估了患者特征(年龄、性别、种族/民族、是否患有慢性病)和就诊特征(到达日期/时间、急性程度、处置、检查(化验和放射检查、药物))。使用多变量回归法评估了患者和就诊特征与使用率和复诊率之间的关系。结果/预期结果:在研究期间,共有 20620 名患者在急诊室就诊 33127 次。33%(n=6842)的患者在一年内就诊超过一次;3964(19.2%)的患者就诊两次,1542(7.5%)的患者就诊三次,1336(6.5%)的患者就诊四次或四次以上。在所有就诊人次中,一半以上(52%)的就诊人次病情较轻。最常见的诊断是呼吸道疾病(27%)、全身状态(包括发烧、病毒性疾病,23%)和胃肠道疾病(15%)。在随访期间,这些诊断仍然是 1 次、2 次、3 次和≥ 4 次急诊就诊者最常见的诊断。随着急诊室就诊次数的增加,年龄较大、非西班牙裔黑人和被分诊为低危重症的儿童比例也有所增加。急诊室就诊次数≥4 次的婴儿更有可能没有慢性病、没有药物或检查单,也更有可能出院。讨论/意义:无慢性病的婴儿急诊室使用率很高,他们最不可能需要药物、检查和住院。随着人们越来越关注医疗保健中的高使用率问题,我们有必要评估婴儿高使用急诊室的原因,并开发相关系统来改善高价值护理,同时减轻资源负担。
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30 Characteristics of Infant Emergency Department Utilization
OBJECTIVES/GOALS: Frequent utilizers of emergency departments (ED) make up a substantial share of overall ED use. Within pediatric emergency departments (PED), infants represent an age group that make up a disproportionate share of PED visits. The objective was to compare patterns of PED use for children less than 1 year of age by visit frequency and resource utilization. METHODS/STUDY POPULATION: Retrospective cohort study of infants less than 1 year presenting to 5 EDs in one health system over a 5-year period, with a 365-day follow-up after each index visit. Patient characteristics (age, sex, race/ethnicity, presence of chronic condition) and visit characteristics (arrival day/time, acuity level, disposition, testing (labs and radiographs, medications) were assessed. The relationship between patient and visit characteristics with utilization and repeat visits was assessed using multivariable regression. RESULTS/ANTICIPATED RESULTS: A total of 20,620 patients with 33,127 ED visits during study timeframe. Thirty three percent (n=6842) had more than one visit in a year; 3964 (19.2%) had two visits, 1542 (7.5%) had three visits, and 1336 (6.5%) had 4 or more visits. Across all visits, over half (52%) were low acuity. The most common diagnoses were respiratory diseases (27%), systemic states (including fever, viral illness, 23%), and gastrointestinal diseases (15%). These diagnoses remained the most common for those with 1, 2, 3, and ≥ 4 ED visits during follow up. As ED visit frequency increased, there was an increase in percentage of children who were older, non-Hispanic Black, and triaged as low acuity. Infants with ≥ 4 ED visits were more likely to be without a chronic condition, have no medications or testing ordered, and be discharged. DISCUSSION/SIGNIFICANCE: There was high ED utilization for those without chronic conditions who were least likely to need medications, testing, and hospital admission. With increasing attention paid to high-utilization in healthcare, it is important to assess why infants use the ED at high rates and develop systems to improve high value care while decreasing resource burden.
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来源期刊
Journal of Clinical and Translational Science
Journal of Clinical and Translational Science MEDICINE, RESEARCH & EXPERIMENTAL-
CiteScore
2.80
自引率
26.90%
发文量
437
审稿时长
18 weeks
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