Cost analysis and provider satisfaction with pediatrician in triage.

Abstract:

OBJECTIVES:The goals of this study were to (1) conduct a cost-benefit analysis, from a hospital's perspective, of using a pediatrician in triage (PIT) in the emergency department (ED) and (2) assess the impact of a physician in triage on provider satisfaction. METHODS:This was a prospective, controlled trial of PIT (intervention) versus conventional registered nurse-driven triage (control), at an urban, academic, tertiary level pediatric ED, which led to a cost-benefit analysis by looking at the effect that PIT has on length of stay (LOS) and thus on ED revenue. Provider satisfaction was assessed through surveys. RESULTS:During the 8-week study period, a total of 6579 patients were triaged: 3242 in the PIT group and 3337 in the control group. The 2 groups were similar in age, sex, admission rate, left-without-being-seen rate, and level of acuity. The mean LOS in the PIT group was 24.3 minutes shorter than in the control group. The costs of PIT seem to be increased and are not offset by savings; the net margin (total revenue minus costs) was $42,883 per year lower in the PIT than in the control group. Sensitivity analysis showed that if the LOS were reduced by more than 98.4 minutes, the cost savings would favor PIT. Most of the physicians and nurses (67%) reported that PIT facilitated their job. CONCLUSIONS:Placement of a PIT during periods of peak census resulted in shorter stay and notable provider satisfaction but at an incremental cost of $42,883 per year.

journal_name

Pediatr Emerg Care

journal_title

Pediatric emergency care

authors

Kezirian J,Muhammad WT,Wan JY,Godambe SA,Pershad J

doi

10.1097/PEC.0b013e31826c6dc4

subject

Has Abstract

pub_date

2012-10-01 00:00:00

pages

971-6

issue

10

eissn

0749-5161

issn

1535-1815

journal_volume

28

pub_type

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