Urban and Rural Patterns in Emergent Pediatric Transfer: A Call for Regionalization
Context National groups call for the regionalization of health care, to direct patients with high‐risk conditions to designated hospitals with greater capabilities. Currently there is limited information detailing the characteristics and specific needs of acutely ill and injured children who require...
Gespeichert in:
| Veröffentlicht in: | The Journal of rural health 2014-06, Vol.30 (3), p.252-258 |
|---|---|
| Hauptverfasser: | , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 258 |
|---|---|
| container_issue | 3 |
| container_start_page | 252 |
| container_title | The Journal of rural health |
| container_volume | 30 |
| creator | Horeczko, Timothy Marcin, James P. Kahn, Jeremy M. Sapien, Robert E. |
| description | Context
National groups call for the regionalization of health care, to direct patients with high‐risk conditions to designated hospitals with greater capabilities. Currently there is limited information detailing the characteristics and specific needs of acutely ill and injured children who require transfer to another institution, especially in underserved rural communities.
Purpose
To determine the epidemiology of pediatric transfers from urban and rural emergency departments (EDs).
Methods
We analyzed data in the National Hospital Ambulatory Medical Care Survey from 1995 to 2010. Eligible children were |
| doi_str_mv | 10.1111/jrh.12051 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1735659226</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1551613371</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5601-c63a4ab07c2ed0dad064da1432e46c4b1795d6b5b105bf75def074780f0db5fe3</originalsourceid><addsrcrecordid>eNqN0U1v1DAQBmALgehSOPAHkCUu5ZB2xp8Jt2rpB2gF1bYV3CwnnpQs2aTYiaD8esJu2wMSor6MD8-8h3kZe4mwj9M7WMWv-yhA4yM2Q6vyDKTBx2wGeQGZNfrLDnuW0gpAFLlUT9mOUGiUVMWMnV_G0nfcd4Evx-hbfuaHgWKXeNPxozXFK-oGfkah8UNsKn4RfZdqim_5IZ_7tuV1H_mSrpq-823zyw_T5zl7Uvs20Yvbucsuj48u5qfZ4tPJ-_nhIqu0AcwqI73yJdhKUIDgAxgVPCopSJlKlWgLHUypSwRd1lYHqsEqm0MNodQ1yV22t829jv33kdLg1k2qqG19R_2YHFqpjS6EMP-nWudFbgqUD6FoJmfxAVQJo0EJmOjrv-iqH-N0s43CXOZmE_hmq6rYpxSpdtexWft44xDcn6rdVLXbVD3ZV7eJY7mmcC_vup3AwRb8aFq6-XeS-7A8vYvMthtNGujn_YaP35yx0mr3-eOJs_JYL_DcunfyNySEvpA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1541838671</pqid></control><display><type>article</type><title>Urban and Rural Patterns in Emergent Pediatric Transfer: A Call for Regionalization</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>PAIS Index</source><source>Applied Social Sciences Index & Abstracts (ASSIA)</source><creator>Horeczko, Timothy ; Marcin, James P. ; Kahn, Jeremy M. ; Sapien, Robert E.</creator><creatorcontrib>Horeczko, Timothy ; Marcin, James P. ; Kahn, Jeremy M. ; Sapien, Robert E. ; Consortium Of Regionalization Efforts in Emergency Medical Services for Children (CORE-EMSC) ; on behalf of the Consortium Of Regionalization Efforts in Emergency Medical Services for Children (CORE‐EMSC)</creatorcontrib><description>Context
National groups call for the regionalization of health care, to direct patients with high‐risk conditions to designated hospitals with greater capabilities. Currently there is limited information detailing the characteristics and specific needs of acutely ill and injured children who require transfer to another institution, especially in underserved rural communities.
Purpose
To determine the epidemiology of pediatric transfers from urban and rural emergency departments (EDs).
Methods
We analyzed data in the National Hospital Ambulatory Medical Care Survey from 1995 to 2010. Eligible children were <18 years of age seen in a United States ED, and transferred to another hospital after initial evaluation.
Findings
Of all 283,232,058 pediatric ED visits, less than 0.5% resulted in a transfer, yielding a population‐based estimate of 900,100 transfers nationally during this period. Urban and rural EDs showed similar transfer rates. Children transferred from rural EDs were older and more likely to arrive by emergency medical services than children transferred from urban EDs (12.1 vs 8.2 years of age, P < .01). Children from rural EDs were more than twice as likely to be transferred for a psychiatric indication (43.5% vs 19.5%, P < .01).
Conclusions
Emergency pediatric transfers are uncommon in the United States; transfer rates are similar in urban and rural settings. Rural children have additional obstacles to care, especially in access to emergency mental health services. Programs to study and implement regionalization of care should consider diverse patient populations and target improvement in coordination of care, transfer times, and outcomes.</description><identifier>ISSN: 0890-765X</identifier><identifier>EISSN: 1748-0361</identifier><identifier>DOI: 10.1111/jrh.12051</identifier><identifier>PMID: 24164349</identifier><identifier>CODEN: JRHEEX</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>access to care ; Accident and emergency departments ; Adolescent ; Child ; Child, Preschool ; Children ; Emergency medical care ; Emergency medical services ; Emergency Service, Hospital - utilization ; Epidemiology ; Female ; health disparities ; Health Policy ; Health Services Accessibility ; Health surveys ; Healthcare Disparities ; Hospitals ; Humans ; Infant ; Infant, Newborn ; Male ; Medical service ; Medically Underserved Area ; mental health ; Mental health services ; Paediatrics ; Patient Transfer - statistics & numerical data ; Patients ; Pediatrics ; policy ; Practice Patterns, Physicians' - statistics & numerical data ; Rural communities ; Rural health care ; Rural Health Services - statistics & numerical data ; Surveys and Questionnaires ; Underserved people ; United States ; Urban areas ; Urban Health Services - statistics & numerical data ; utilization of health services</subject><ispartof>The Journal of rural health, 2014-06, Vol.30 (3), p.252-258</ispartof><rights>2013 National Rural Health Association</rights><rights>2013 National Rural Health Association.</rights><rights>2014 National Rural Health Association</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5601-c63a4ab07c2ed0dad064da1432e46c4b1795d6b5b105bf75def074780f0db5fe3</citedby><cites>FETCH-LOGICAL-c5601-c63a4ab07c2ed0dad064da1432e46c4b1795d6b5b105bf75def074780f0db5fe3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjrh.12051$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjrh.12051$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,778,782,1414,27852,27853,27911,27912,30986,30987,45561,45562</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24164349$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Horeczko, Timothy</creatorcontrib><creatorcontrib>Marcin, James P.</creatorcontrib><creatorcontrib>Kahn, Jeremy M.</creatorcontrib><creatorcontrib>Sapien, Robert E.</creatorcontrib><creatorcontrib>Consortium Of Regionalization Efforts in Emergency Medical Services for Children (CORE-EMSC)</creatorcontrib><creatorcontrib>on behalf of the Consortium Of Regionalization Efforts in Emergency Medical Services for Children (CORE‐EMSC)</creatorcontrib><title>Urban and Rural Patterns in Emergent Pediatric Transfer: A Call for Regionalization</title><title>The Journal of rural health</title><addtitle>The Journal of Rural Health</addtitle><description>Context
National groups call for the regionalization of health care, to direct patients with high‐risk conditions to designated hospitals with greater capabilities. Currently there is limited information detailing the characteristics and specific needs of acutely ill and injured children who require transfer to another institution, especially in underserved rural communities.
Purpose
To determine the epidemiology of pediatric transfers from urban and rural emergency departments (EDs).
Methods
We analyzed data in the National Hospital Ambulatory Medical Care Survey from 1995 to 2010. Eligible children were <18 years of age seen in a United States ED, and transferred to another hospital after initial evaluation.
Findings
Of all 283,232,058 pediatric ED visits, less than 0.5% resulted in a transfer, yielding a population‐based estimate of 900,100 transfers nationally during this period. Urban and rural EDs showed similar transfer rates. Children transferred from rural EDs were older and more likely to arrive by emergency medical services than children transferred from urban EDs (12.1 vs 8.2 years of age, P < .01). Children from rural EDs were more than twice as likely to be transferred for a psychiatric indication (43.5% vs 19.5%, P < .01).
Conclusions
Emergency pediatric transfers are uncommon in the United States; transfer rates are similar in urban and rural settings. Rural children have additional obstacles to care, especially in access to emergency mental health services. Programs to study and implement regionalization of care should consider diverse patient populations and target improvement in coordination of care, transfer times, and outcomes.</description><subject>access to care</subject><subject>Accident and emergency departments</subject><subject>Adolescent</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Emergency medical care</subject><subject>Emergency medical services</subject><subject>Emergency Service, Hospital - utilization</subject><subject>Epidemiology</subject><subject>Female</subject><subject>health disparities</subject><subject>Health Policy</subject><subject>Health Services Accessibility</subject><subject>Health surveys</subject><subject>Healthcare Disparities</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Male</subject><subject>Medical service</subject><subject>Medically Underserved Area</subject><subject>mental health</subject><subject>Mental health services</subject><subject>Paediatrics</subject><subject>Patient Transfer - statistics & numerical data</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>policy</subject><subject>Practice Patterns, Physicians' - statistics & numerical data</subject><subject>Rural communities</subject><subject>Rural health care</subject><subject>Rural Health Services - statistics & numerical data</subject><subject>Surveys and Questionnaires</subject><subject>Underserved people</subject><subject>United States</subject><subject>Urban areas</subject><subject>Urban Health Services - statistics & numerical data</subject><subject>utilization of health services</subject><issn>0890-765X</issn><issn>1748-0361</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><sourceid>7TQ</sourceid><recordid>eNqN0U1v1DAQBmALgehSOPAHkCUu5ZB2xp8Jt2rpB2gF1bYV3CwnnpQs2aTYiaD8esJu2wMSor6MD8-8h3kZe4mwj9M7WMWv-yhA4yM2Q6vyDKTBx2wGeQGZNfrLDnuW0gpAFLlUT9mOUGiUVMWMnV_G0nfcd4Evx-hbfuaHgWKXeNPxozXFK-oGfkah8UNsKn4RfZdqim_5IZ_7tuV1H_mSrpq-823zyw_T5zl7Uvs20Yvbucsuj48u5qfZ4tPJ-_nhIqu0AcwqI73yJdhKUIDgAxgVPCopSJlKlWgLHUypSwRd1lYHqsEqm0MNodQ1yV22t829jv33kdLg1k2qqG19R_2YHFqpjS6EMP-nWudFbgqUD6FoJmfxAVQJo0EJmOjrv-iqH-N0s43CXOZmE_hmq6rYpxSpdtexWft44xDcn6rdVLXbVD3ZV7eJY7mmcC_vup3AwRb8aFq6-XeS-7A8vYvMthtNGujn_YaP35yx0mr3-eOJs_JYL_DcunfyNySEvpA</recordid><startdate>20140601</startdate><enddate>20140601</enddate><creator>Horeczko, Timothy</creator><creator>Marcin, James P.</creator><creator>Kahn, Jeremy M.</creator><creator>Sapien, Robert E.</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7T2</scope><scope>7TQ</scope><scope>C1K</scope><scope>DHY</scope><scope>DON</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>7U1</scope><scope>7U2</scope></search><sort><creationdate>20140601</creationdate><title>Urban and Rural Patterns in Emergent Pediatric Transfer: A Call for Regionalization</title><author>Horeczko, Timothy ; Marcin, James P. ; Kahn, Jeremy M. ; Sapien, Robert E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5601-c63a4ab07c2ed0dad064da1432e46c4b1795d6b5b105bf75def074780f0db5fe3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>access to care</topic><topic>Accident and emergency departments</topic><topic>Adolescent</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Emergency medical care</topic><topic>Emergency medical services</topic><topic>Emergency Service, Hospital - utilization</topic><topic>Epidemiology</topic><topic>Female</topic><topic>health disparities</topic><topic>Health Policy</topic><topic>Health Services Accessibility</topic><topic>Health surveys</topic><topic>Healthcare Disparities</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Male</topic><topic>Medical service</topic><topic>Medically Underserved Area</topic><topic>mental health</topic><topic>Mental health services</topic><topic>Paediatrics</topic><topic>Patient Transfer - statistics & numerical data</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>policy</topic><topic>Practice Patterns, Physicians' - statistics & numerical data</topic><topic>Rural communities</topic><topic>Rural health care</topic><topic>Rural Health Services - statistics & numerical data</topic><topic>Surveys and Questionnaires</topic><topic>Underserved people</topic><topic>United States</topic><topic>Urban areas</topic><topic>Urban Health Services - statistics & numerical data</topic><topic>utilization of health services</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Horeczko, Timothy</creatorcontrib><creatorcontrib>Marcin, James P.</creatorcontrib><creatorcontrib>Kahn, Jeremy M.</creatorcontrib><creatorcontrib>Sapien, Robert E.</creatorcontrib><creatorcontrib>Consortium Of Regionalization Efforts in Emergency Medical Services for Children (CORE-EMSC)</creatorcontrib><creatorcontrib>on behalf of the Consortium Of Regionalization Efforts in Emergency Medical Services for Children (CORE‐EMSC)</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>PAIS Index</collection><collection>Environmental Sciences and Pollution Management</collection><collection>PAIS International</collection><collection>PAIS International (Ovid)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>Risk Abstracts</collection><collection>Safety Science and Risk</collection><jtitle>The Journal of rural health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Horeczko, Timothy</au><au>Marcin, James P.</au><au>Kahn, Jeremy M.</au><au>Sapien, Robert E.</au><aucorp>Consortium Of Regionalization Efforts in Emergency Medical Services for Children (CORE-EMSC)</aucorp><aucorp>on behalf of the Consortium Of Regionalization Efforts in Emergency Medical Services for Children (CORE‐EMSC)</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Urban and Rural Patterns in Emergent Pediatric Transfer: A Call for Regionalization</atitle><jtitle>The Journal of rural health</jtitle><addtitle>The Journal of Rural Health</addtitle><date>2014-06-01</date><risdate>2014</risdate><volume>30</volume><issue>3</issue><spage>252</spage><epage>258</epage><pages>252-258</pages><issn>0890-765X</issn><eissn>1748-0361</eissn><coden>JRHEEX</coden><abstract>Context
National groups call for the regionalization of health care, to direct patients with high‐risk conditions to designated hospitals with greater capabilities. Currently there is limited information detailing the characteristics and specific needs of acutely ill and injured children who require transfer to another institution, especially in underserved rural communities.
Purpose
To determine the epidemiology of pediatric transfers from urban and rural emergency departments (EDs).
Methods
We analyzed data in the National Hospital Ambulatory Medical Care Survey from 1995 to 2010. Eligible children were <18 years of age seen in a United States ED, and transferred to another hospital after initial evaluation.
Findings
Of all 283,232,058 pediatric ED visits, less than 0.5% resulted in a transfer, yielding a population‐based estimate of 900,100 transfers nationally during this period. Urban and rural EDs showed similar transfer rates. Children transferred from rural EDs were older and more likely to arrive by emergency medical services than children transferred from urban EDs (12.1 vs 8.2 years of age, P < .01). Children from rural EDs were more than twice as likely to be transferred for a psychiatric indication (43.5% vs 19.5%, P < .01).
Conclusions
Emergency pediatric transfers are uncommon in the United States; transfer rates are similar in urban and rural settings. Rural children have additional obstacles to care, especially in access to emergency mental health services. Programs to study and implement regionalization of care should consider diverse patient populations and target improvement in coordination of care, transfer times, and outcomes.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>24164349</pmid><doi>10.1111/jrh.12051</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0890-765X |
| ispartof | The Journal of rural health, 2014-06, Vol.30 (3), p.252-258 |
| issn | 0890-765X 1748-0361 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1735659226 |
| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; PAIS Index; Applied Social Sciences Index & Abstracts (ASSIA) |
| subjects | access to care Accident and emergency departments Adolescent Child Child, Preschool Children Emergency medical care Emergency medical services Emergency Service, Hospital - utilization Epidemiology Female health disparities Health Policy Health Services Accessibility Health surveys Healthcare Disparities Hospitals Humans Infant Infant, Newborn Male Medical service Medically Underserved Area mental health Mental health services Paediatrics Patient Transfer - statistics & numerical data Patients Pediatrics policy Practice Patterns, Physicians' - statistics & numerical data Rural communities Rural health care Rural Health Services - statistics & numerical data Surveys and Questionnaires Underserved people United States Urban areas Urban Health Services - statistics & numerical data utilization of health services |
| title | Urban and Rural Patterns in Emergent Pediatric Transfer: A Call for Regionalization |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-15T18%3A57%3A46IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Urban%20and%20Rural%20Patterns%20in%20Emergent%20Pediatric%20Transfer:%20A%20Call%20for%20Regionalization&rft.jtitle=The%20Journal%20of%20rural%20health&rft.au=Horeczko,%20Timothy&rft.aucorp=Consortium%20Of%20Regionalization%20Efforts%20in%20Emergency%20Medical%20Services%20for%20Children%20(CORE-EMSC)&rft.date=2014-06-01&rft.volume=30&rft.issue=3&rft.spage=252&rft.epage=258&rft.pages=252-258&rft.issn=0890-765X&rft.eissn=1748-0361&rft.coden=JRHEEX&rft_id=info:doi/10.1111/jrh.12051&rft_dat=%3Cproquest_cross%3E1551613371%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1541838671&rft_id=info:pmid/24164349&rfr_iscdi=true |