Repeat pediatric visits to a general emergency department

Zimmerman, Deena; McCarten-Gibbs, Kevan A; DeNoble, Denise H; Borger, Caryn; Fleming, Jacqueline; Hsieh, Margaret; Langer, Jessica; Breckenridge, Mary B.

doi:10.1016/s0045-9380(97)80020-5

Cited by 10 publications

(27 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the general medical literature, early representations range from 0.4% to 5.5% in the adult population, 2,11 and from 3.3% to 13.4% in the paediatric population. 1,[12][13][14] Our representation rate of 4.9% was higher than many of the other studies conducted. Comparisons with these studies are difficult as there were significant differences in the study designs ( Table 5).…”

Section: Discussioncontrasting

confidence: 65%

“…Previous studies have demonstrated that geriatric and paediatric groups both generally have higher admission rates on representation to the ED. 1,6,[12][13][14] This is thought to be because of multiple medical comorbidities in the geriatric group, and in the paediatric group, patients that represent tend to be more acutely unwell than in the adult group. 14,23 Surprisingly in our data set, this was not reflected, with the admission rate being similar across all age groups.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Early emergency department representations

Robinson

Lam

2013

Emerg Medicine Australasia

View full text Add to dashboard Cite

show abstract

Section: Discussioncontrasting

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Early emergency department representations

Robinson

Lam

2013

Emerg Medicine Australasia

View full text Add to dashboard Cite

show abstract

“…In our study and others, repeat EMS use and ED use by pediatric patients are often associated with chronic illnesses. 9 Whereas Zimmerman et al found repeat ED visits were more likely to be for respiratory complaints, 12 Yamamoto et al found chronic conditions (e.g., cerebral palsy, seizures) were the most common reason for multiple ambulance transports, followed by wheezing and trauma. 9 Chronic illnesses often lead to repeat emergent medical needs.…”

Section: Discussionmentioning

confidence: 99%

“…To characterize recurrent EMS pediatric transports, we compared transport data of patients transported by ambulance more than one time with data for those transported only once with regard to age, gender, chief complaint, and payment source. Based on available literature, we hypothesized that: 1) the prevalence of repeat EMS use would follow a bimodal age distribution as does the overall EMS pediatric population, 5,9,12 with peaks at ages 0-11.9 months and 11-16.9 years; 2) chief complaints of patients with repeat transports would differ from those of patients with single transports; and 3) repeat transports would be disproportionately reimbursed by public insurance.…”

mentioning

confidence: 99%

Repeat Ambulance Use by Pediatric Patients

Broxterman

Sapién

Fullerton

et al. 2000

Academic Emergency Medicine

View full text Add to dashboard Cite

Abstract. Objective: To compare pediatric patients transported by ambulance on more than one occasion (repeat) with those transported only once. Methods: The authors analyzed pediatric (patient < 21 years old) transports for 1992-1995 by the ambulance service that provides 99% of transports for a non-innercity metropolitan area. Repeat transports were compared with single transports with regard to patient age, gender, chief complaint, and payment source. Results: There were 17,448 transports involving 15,168 patients. Nearly half (49.0%) of the repeat transports involved patients in the oldest age category, 17 to 20.9 years, contrasted with 38.0% of single transports (p < 0.00001). Females comprised 51.4% of the repeat transports and 48.5% of the single transports (p = 0.0008). Traumatic complaints accounted for onethird (33.0%) of the repeat transports and half (51.1%) of the single transports (p < 0.0001). Chief complaints of the patients with repeat transports were more likely to be seizure, assault, abdominal pain, and respiratory problems, and less likely to be falls and motor vehicle-related complaints, than chief complaints of the patients with single transports (p < 0.0001). More than one-third (39.0%) of the repeat transports were funded by Medicaid, in contrast with 19.8% of the single transports (p < 0.0001). Conclusions: Compared with single transports, repeat transports were more likely to involve patients more than 16 years of age, female, and with a chief complaint of seizure, assault, abdominal pain, or respiratory distress, and more likely to be funded by public insurance (Medicaid). Repeat pediatric transports warrant further investigation. This information may be useful in designing interventions targeted at reducing emergencies and hence ambulance use. Key words: repeat emergency medical service; pediatric emergency medical service; ambulance; adolescents; health care financing. ACADEMIC EMERGENCY MEDICINE 2000; 7:36-41 I N RECENT years, pediatric emergency medical services (EMS) have received increasing attention, but research needs are still great.1,2 Children constitute 6-10% of all EMS transports.1,3-6 Analysis of EMS data is an underutilized method for following trends in ambulance use.7 Data from an EMS service can provide comprehensive, community-wide information. In contrast, data from a single hospital do not include information on patients who are transported repeatedly, but are treated at more than one ED. Research has been done on adult repeat EMS use. acute alcohol intoxication, and respiratory conditions involved only 4.3% of patients, yet accounted for 28.4% of transports.8 Only one study, by Yamamoto et al.,9 analyzed data on repeat EMS use in children. The Yamamoto study, however, had a small sample size (n = 36) of children transported more than once. Therefore, it is difficult to generalize these results. Developing a profile of individuals at high risk for repeat use of EMS may help in the development of targeted prevention activities. 10,11 The prevalence of repeat EM...

show abstract

“…In recent years, much research has focused on the implications of managed care and different types of insurance on ED use (Butler 1998;Chande, Krug, and Warm 1996;Gadomski et al 1995;Holl et al 2000;Hodge 1999). Other pediatric research examines characteristics of children who are frequent ED users or who visit the ED as their usual source of care (Bond, Stearns, and Peters 1999;Halfon et al 1996;Wilson and Klein 2000;Yamamoto et al 1995;Zimmerman et al 1996).…”

mentioning

confidence: 99%

Emergency Department Use among Michigan Children with Special Health Care Needs: An Introductory Study

Pollack

Dombkowski

Zimmerman

et al. 2004

Health Services Research

View full text Add to dashboard Cite

Objective. To describe patterns of emergency department (ED) use among children dual-enrolled in Medicaid and Michigan's Children's Special Health Care Services (CSHCS). Data Sources. Individual claims and enrollment data from Michigan's Medicaid and CSHCS programs for the period January 1, 1998, to June 30, 1999. Claims data were linked with eligibility data and then used to develop a 100 percent sample of claims for individuals enrolled in both Medicaid and CSHCS. Study Design. Poisson regression analysis was used to examine the rate of ED use for dual-enrolled children. A time-varying hazard analysis was also used to examine the impact of changes over time. The key variables were gender, age, race, county of residence, Medicaid eligibility category, and qualifying diagnosis. Principal Findings. Dual-enrolled children under one year of age, and those with qualifying diagnoses of anemia, hemophilia, asthma, epilepsy, and juvenile diabetes displayed especially high rates of ED use. Significant geographic variation in ED use remained after controlling for qualifying diagnoses, race/ethnicity, and other factors. African Americans displayed higher rates of ED utilization than non-Hispanic whites. Supplemental Security Income (SSI) recipients demonstrated higher utilization than other groups. Conclusions. Children dually enrolled in CSHCS and Medicaid face diverse challenges of both poverty and chronic illness. Differences in patterns of use highlight the importance, but also the difficulty, of developing systems of care to manage complex chronic conditions in low-income populations.

show abstract

Repeat pediatric visits to a general emergency department

Cited by 10 publications

References 10 publications

Early emergency department representations

Early emergency department representations

Repeat Ambulance Use by Pediatric Patients

Emergency Department Use among Michigan Children with Special Health Care Needs: An Introductory Study

Contact Info

Product

Resources

About