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

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.

doi:10.1016/j.jpeds.2015.05.047

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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

Published Date:

Jul 02 2015

Publisher's site:

http://dx.doi.org/10.1016/j.jpeds.2015.05.047 New Site Icon

Source:

J Pediatr. 167(3):711-718.e4.

[PDF-636.59 KB]

Details:

Personal Authors:

Macy, Michelle L. ; Zonfrillo, Mark R. ; Cook, Lawrence J. ; Funai, Tomohiko ; Goldstick, Jason ; ... More ▼

Keywords:

[+]

Pubmed ID:

26141551

Pubmed Central ID:

PMC4554798

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.

Document Type:

Journal Article

Collection(s):

CDC Public Access

Funding:

5K08HD073241-02/HD/NICHD NIH HHS/United States
K08 HD073241/HD/NICHD NIH HHS/United States
K23 HD070913/HD/NICHD NIH HHS/United States
K23 HD070913/HD/NICHD NIH HHS/United States
R49CE002099/CE/NCIPC CDC HHS/United States
U03MC00001/PHS HHS/United States
U03MC00003/PHS HHS/United States
U03MC00006/PHS HHS/United States
U03MC00007/PHS HHS/United States
U03MC00008/PHS HHS/United States
U03MC22684/PHS HHS/United States
U03MC22685/PHS HHS/United States

Main Document Checksum:

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Supporting Files:

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	nihms696729f1.jpg	image/jpeg

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