Abstract:
OBJECTIVE:Outcomes of emergency care delivered to children vary by patient-level socioeconomic factors and by emergency department (ED) characteristics, including pediatric volume. How these factors intersect in emergency care-seeking patterns among children is not well understood. The objective of this study was to characterize national associations of neighborhood income and insurance type of children with the characteristics of the EDs from which they receive care. METHODS:We conducted a cross-sectional study of ED visits by children from 2014 to 2017 using the Nationwide Emergency Department Sample. We determined the associations of neighborhood income and patient insurance type with the proportions of visits to EDs by pediatric volume category, both unadjusted and adjusted for patient-level factors including urban-rural status of residence. RESULTS:Of 107.6 million ED visits by children nationally from 2014 to 2017, children outside of the wealthiest neighborhood income quartile had lower proportions of visits to high-volume pediatric EDs (57.1% poorest quartile, 51.5% second, 56.6% third, 63.5% wealthiest) and greater proportions of visits to low-volume pediatric EDs (4.4% poorest, 6.4% second, 4.6% third, 2.3% wealthiest) than children in the wealthiest quartile. Adjustment for patient-level factors, particularly urban-rural status, inverted this association, revealing that lower neighborhood income was independently associated with visiting higher-volume pediatric EDs. Publicly insured children were modestly more likely to visit higher-volume pediatric EDs than privately insured and uninsured children in both unadjusted and adjusted analyses. CONCLUSIONS:Nationally, children in lower-income neighborhoods tended to receive care in pediatric EDs with lower volume, an association that appears principally driven by urban-rural differences in access to emergency care.
journal_name
Pediatr Emerg Carejournal_title
Pediatric emergency careauthors
Chang L,Rees CA,Michelson KAdoi
10.1097/PEC.0000000000002244subject
Has Abstractpub_date
2020-09-16 00:00:00eissn
0749-5161issn
1535-1815pub_type
杂志文章abstract:OBJECTIVES:The purpose of this study was to describe a single institutional experience with pediatric diffuse pulmonary hemorrhage, with an emphasis on etiology, clinical course, and outcome. METHODS:The medical records of pediatric patients admitted to Assaf Harofeh Medical Center between the years 2002 and 2011 beca...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318271c107
更新日期:2012-11-01 00:00:00
abstract::The delayed presentation of a congenital diaphragmatic hernia may include symptoms of acute respiratory distress or gastrointestinal obstruction. We review the presentation and management of the different types of diaphragmatic hernias. In addition, we present a case of twins with a left-sided congenital diaphragmatic...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-200108000-00013
更新日期:2001-08-01 00:00:00
abstract::Atypical manifestations of acute hepatitis A virus (HAV) infection include ascites, pleural effusion, acute renal failure, aplastic anemia, and neurological manifestations. Although association of HAV and acute cholecystitis is known, presentation of hepatitis A infection with acute cholecystitis has not been reported...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318258bdda
更新日期:2012-06-01 00:00:00
abstract::The expression of cardiac dysfunction in pediatric patients with myocarditis may not be conspicuous. While older children with myocarditis may abruptly present with pleuritic or angina-like pain, infants and toddlers with fulminant disease are unable to verbalize such complaints. Cardiac compromise in preverbal childr...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199204000-00017
更新日期:1992-04-01 00:00:00
abstract::Owing to its lower incidence in young children, appendicitis is not as often thought of as a common cause of abdominal pain and vomiting in this age group. However, because of its higher incidence of morbidity (perforation and peritonitis), it should be considered in any young child with either significant abdominal p...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199710000-00012
更新日期:1997-10-01 00:00:00
abstract::Etizolam (ETZ) is an antidepressive thienodiazepine drug that is used worldwide. The most frequent adverse effects in adults are drowsiness and muscle weakness, and this can rarely cause paradoxical excitation; however, no information exists on intoxication in children. Furthermore, evidence bearing on its safety in c...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000280511.13537.bd
更新日期:2007-07-01 00:00:00
abstract::The diagnosis of pulmonary thromboembolism (PE) is often delayed because it is usually misdiagnosed as pneumonia or deep vein thrombosis. We report an unusual case of PE misdiagnosed as viral pleuritis on the first arrival at the emergency department (ED) in our hospital. A 14-year-old girl with no previous significan...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001104
更新日期:2018-11-01 00:00:00
abstract:OBJECTIVES:The majority of US children do not have access to an emergency department (ED) with a pediatric mental health care policy in place. Our objective was to understand factors associated with whether US EDs have a pediatric mental health care policy. METHODS:We analyzed data from the National Pediatric Readines...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001920
更新日期:2019-11-13 00:00:00
abstract::Accurate rhythm identification is vital for appropriate shock delivery during pediatric resuscitation with an automated external defibrillator. Currently, extensive testing of pediatric algorithms is recommended. The aims of our study were to determine age-related differences in electrocardiographic (ECG) tracings in ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000149
更新日期:2014-12-01 00:00:00
abstract:OBJECTIVES:Although National Asthma Guidelines recommend that emergency department (ED) physicians consider initiating controller medications, research suggests that this practice occurs infrequently. The goal of this study was to assess primary care pediatricians' (PCP) beliefs and attitudes regarding ED initiation of...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000389
更新日期:2015-08-01 00:00:00
abstract::The Pediatric Assessment Triangle (PAT) has become the cornerstone for the Pediatric Education for Prehospital Professionals course, sponsored by the American Academy of Pediatrics. This concept for emergency assessment of children has been taught to more than 170,000 health care providers worldwide. It has been incor...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181d6db37
更新日期:2010-04-01 00:00:00
abstract::Anticoagulation for thromboembolic disease and bleeding, the main complication of anticoagulation therapy, are uncommon but are potentially life- or limb-threatening conditions that may present in the pediatric emergency department. Thromboembolic disease in children usually occurs as a complication of vascular access...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/PEC.0b013e31820461b1
更新日期:2011-01-01 00:00:00
abstract:OBJECTIVE:We examined financial barriers to care experienced by US school-aged children with disabilities. METHODS:Data from the 2005 National Health Interview Survey were analyzed. Children aged 5 to 17 years were classified into 4 health condition groups: children with activity limitations, disabling conditions, chr...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318180fda3
更新日期:2008-08-01 00:00:00
abstract:UNLABELLED:Clavicle fractures are a common injury among pediatric patients. Few data exist regarding specific etiologies and their management in the preadolescent patient. Our objective was to determine the specific source of injury and treatment techniques used in the youngest patient population. METHODS:Study Design...
journal_title:Pediatric emergency care
pub_type: 杂志文章,多中心研究
doi:10.1097/PEC.0b013e3181bec7fc
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:Pediatric traumatic brain injury (TBI) and abusive head trauma (AHT) are leading causes of morbidity and mortality. Clinicians may not be aware of AHT at presentation to the emergency department (ED). OBJECTIVE:The objective of this study was to determine which clinical features associated with head injury ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002239
更新日期:2020-09-10 00:00:00
abstract::Obstruction caused by strangulation internal hernia secondary to incarceration within the falciform ligament, although rare, has been previously reported in the literature. These cases, however, were unrelated to trauma. We report on the first case in the pediatric literature of a strangulated internal hernia secondar...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181e15e7d
更新日期:2010-06-01 00:00:00
abstract:OBJECTIVES:This study examined how much parents are willing to pay and/or willing to stay to make their child's intravenous (IV) catheter placement painless. METHODS:A prospective survey was conducted using a questionnaire administered to a consecutive sample of parents presenting to an emergency department (ED). Elig...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000238743.96606.69
更新日期:2006-11-01 00:00:00
abstract:OBJECTIVES:To describe the characteristics of childhood poisoning leading to consultation to 17 pediatric emergency departments in Spain. METHODS:During a 2-year period (January 2001 to December 2002), accompanying people of 2157 children with acute intoxication who visited consecutively at the emergency room were pro...
journal_title:Pediatric emergency care
pub_type: 杂志文章,多中心研究
doi:10.1097/01.pec.0000215651.50008.1b
更新日期:2006-05-01 00:00:00
abstract::Hair-thread tourniquet syndrome is defined as the ischemic strangulation of hair resulting in edema and severe pain and may cause amputation of organs. Strangulation of the external genitalia (clitoris, labia minora) has rarely been described in girls. Here, we present a case of hypertrophic clitoris injury secondary ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000341
更新日期:2015-05-01 00:00:00
abstract::Pediatric emergency physicians must have a high clinical suspicion for atlantoaxial rotatory subluxation (AARS), particularly when a child presents with neck pain and an abnormal head posture without the ability to return to a neutral position. As shown in the neurosurgical literature, timely diagnosis and swift initi...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/PEC.0000000000000817
更新日期:2016-10-01 00:00:00
abstract::To determine the accuracy and reliability of a labeled leukocyte imaging technique in the early diagnosis of pediatric appendicitis, we prospectively studied patients presenting to the pediatric emergency department with abdominal pain suggestive of appendicitis. Patients scheduled for urgent laparotomy were excluded,...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199510000-00005
更新日期:1995-10-01 00:00:00
abstract:BACKGROUND:In September 2005, Texas Children's Hospital initiated a protocol for all neonates presenting to the emergency department (ED) with hyperbilirubinemia based on the American Academy of Pediatrics guidelines. As part of the protocol, low-risk neonates with hyperbilirubinemia requiring phototherapy are treated ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181db2058
更新日期:2010-05-01 00:00:00
abstract::Honeycomb gallbladder is a rare congenital malformation of the gallbladder. In some cases, it may be asymptomatic, whereas in others, it may lead to symptoms consistent with biliary colic even in the absence of cholelithiasis. We present the clinical and imaging findings of a case of a 10-year-old boy who was admitted...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000030
更新日期:2013-12-01 00:00:00
abstract:BACKGROUND:Life-saving procedures are rarely performed on children in the emergency department, making it difficult for trainees to acquire the skills necessary to provide proficient resuscitative care for children. Studies have demonstrated that residents in general pediatrics and emergency medicine lack exposure to p...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002195
更新日期:2020-08-28 00:00:00
abstract:OBJECTIVE:The aim of this study was to evaluate the accuracy of the initial impression of emergency department providers on the disposition of children with asthma exacerbation. METHODS:We conducted a prospective survey of physicians and other providers in the emergency department of a children's hospital and parents ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001723
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVES:To determine the percentage of cases of epididymitis in pediatric patients that is of bacterial cause and to identify factors that predict a positive urine culture. METHODS:We conducted a retrospective chart review of patients diagnosed with acute epididymitis or epididymo-orchitis in 1 pediatric emergency ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31820d647a
更新日期:2011-03-01 00:00:00
abstract:OBJECTIVES:The objectives of this study were (1) to evaluate dog bite-related injuries and associated medical documentation and (2) to compare these results with a study of dog bites from the same institution 10 years prior. METHODS:Data were retrospectively collected from a pediatric emergency department from July 20...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001132
更新日期:2019-09-01 00:00:00
abstract::Immune thrombocytopenia (ITP) in children is usually a benign, self-limiting disorder. An acute Epstein-Barr virus (EBV) infection usually causes atypical lymphocytosis and mild decrease in platelets. Severe thrombocytopenia is an extremely rare complication. Anti-D immunoglobulin has been used for treatment of ITP in...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318294f3a5
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND:Single-use detergent sacs (SUDS) are widely used in North America and Europe with emerging literature on their toxicity. This is the first Canadian multicenter study aimed to quantify and compare SUDS exposures to traditional detergent exposures. METHODS:A retrospective review of the Canadian Hospitals Inju...
journal_title:Pediatric emergency care
pub_type: 杂志文章,多中心研究
doi:10.1097/PEC.0000000000000835
更新日期:2018-10-01 00:00:00
abstract::A 4-year-old boy, who had no prior history of convulsions, presented with inability to walk, disequilibrium, dysarthria (incoherent speech), and impaired cognition (disorientation) following the instillation of 1% cyclopentolate, a commonly used mydriatic in pediatric practice. This case demonstrates the uncommon, alt...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3182417a63
更新日期:2012-01-01 00:00:00