Patient and Community-Level Socio-Demographic Characteristics Associated with Emergency Department Visits for Childhood Injury; A Retrospective Analysis of Data from the Pediatric Emergency Care Applied Research Network (PECARN) Core Data Project 2004–2008

Details

• Alternative Title:
  J Pediatr
• Personal Author:
  Macy, Michelle L. ; Zonfrillo, Mark R. ; Cook, Lawrence J. ; Funai, Tomohiko ; Goldstick, Jason ; Stanley, Rachel M. ; Chamberlain, James M. ; Cunningham, Rebecca M. ; Lipton, Robert ; Alpern, Elizabeth R.
• Description:
  Objective
  
  To examine pediatric emergency department (ED) visits over 5 years, trends in injury severity, and associations between injury-related ED visit outcome and patient and community-level socio-demographic characteristics.
  
  Study design
  
  Retrospective analysis of administrative data provided to the Pediatric Emergency Care Applied Research Network Core Data Project, 2004–2008. Home addresses were geocoded to determine census block group and associated socio-demographic characteristics. Maximum Abbreviated Injury Scale severity and Severity Classification System scores were calculated. Generalized estimating equations were used to test for associations between socio-demographic characteristics and admission or transfer among injury-related ED visits.
  
  Results
  
  Overall ED visits and injury-related visits increased from 2004 to 2008 at study sites. Of 2,833,676 successfully geocoded visits, 700,821 (24.7%) were injury-related. The proportion of higher severity injury-related visits remained consistent. Nearly 10% of injury-related visits resulted in admission or transfer each year. After adjusting for age, sex, payer, and injury severity, odds of admission or transfer were lower among minority children and children from areas with moderate and high prevalence of poverty.
  
  Conclusions
  
  Pediatric injury-related ED visits to included sites increased over the study period while injury severity, anticipated resource utilization, and visit outcomes remained stable, with low rates of admission or transfer. Socio-demographic differences in injury-related visits and ED disposition were apparent. ED-based injury surveillance is essential to understand disparities, inform targets for prevention programs, and reduce the overall burden of childhood injuries.
  
  
• Subjects:
  Abbreviated Injury Scale Child Child, Preschool Emergency Service, Hospital Female Humans Infant Infant, Newborn Insurance, Health Male Medically Uninsured Minority Groups Patient Admission Patient Transfer Poverty Racial Groups Retrospective Studies Severity Of Illness Index United States Wounds And Injuries

  More +
• Keywords:
  Hospital Admission Injury Severity Pediatric Trends
• Source:
  J Pediatr. 167(3):711-718.e4
• Pubmed ID:
  26141551
• Pubmed Central ID:
  PMC4554798
• Document Type:
  Journal Article
• Funding:
  U03MC00006/PHS HHSUnited States/ ; U03MC22685/PHS HHSUnited States/ ; R49CE002099/CE/NCIPC CDC HHSUnited States/ ; 5K08HD073241-02/HD/NICHD NIH HHSUnited States/ ; U03MC00008/PHS HHSUnited States/ ; K08 HD073241/HD/NICHD NIH HHSUnited States/ ; U03MC00007/PHS HHSUnited States/ ; R49CE002099/ACL/ACL HHSUnited States/ ; U03MC00003/PHS HHSUnited States/ ; U01 CE002698/CE/NCIPC CDC HHSUnited States/ ; U03MC22684/PHS HHSUnited States/ ; U03MC00001/PHS HHSUnited States/ ; K23 HD070913/HD/NICHD NIH HHSUnited States/
• Volume:
  167
• Issue:
  3
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:684f03171de7bc55246a5ac5e5fb5da41ae3bc148e59053525e074672ef87cd1ca66a3e73305d94bb3c9e7be2988b67672a68c4b45745cb6e25ebbfa391aac01
• Download URL:
  https://stacks.cdc.gov/view/cdc/35672/cdc_35672_DS1.pdf
• File Type:
  [PDF - 636.59 KB ]