Caregiver Perceptions Regarding Alternative Emergency Medical Services Dispositions for Children: A Cross-Sectional Survey Analysis
Introduction: Emergency medical services (EMS) systems have developed alternative disposition processes for patients (including leaving the patient at the scene, using taxis, and transporting to clinics) vs taking patients directly to an emergency department (ED). Studies show that patients favorabl...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
eScholarship Publishing, University of California
2022-07-01
|
| Series: | Western Journal of Emergency Medicine |
| Online Access: | https://escholarship.org/uc/item/896847jd |
| _version_ | 1798037357198311424 |
|---|---|
| author | Caleb E. Ward Jonathan Gougelet Ryan Pearman Gia M. Badolato Joelle N. Simpson |
| author_facet | Caleb E. Ward Jonathan Gougelet Ryan Pearman Gia M. Badolato Joelle N. Simpson |
| author_sort | Caleb E. Ward |
| collection | DOAJ |
| description | Introduction: Emergency medical services (EMS) systems have developed alternative disposition processes for patients (including leaving the patient at the scene, using taxis, and transporting to clinics) vs taking patients directly to an emergency department (ED). Studies show that patients favorably support these alternative options but have not included the perspectives of caregivers of children. Our objective was to describe caregivers’ views about these alternative disposition processes and analyze whether caregiver support is associated with sociodemographic factors. Methods: We surveyed a convenience sample of caregivers in a pediatric ED. We asked caregivers 15 questions based on a previously validated survey. We then conducted logistic regressions to determine whether sociodemographic factors were associated with levels of support. Results: We enrolled 241 caregivers. The median age of their children was five years. The majority of respondents were non-Hispanic Black (57%) and had public insurance (65%). We found that a majority of respondents supported all alternative EMS disposition options. The overall level of agreement for survey questions ranged from 51–93%. We grouped questions by theme: non-transport; alternative destinations; communication with EMS physician; communication with primary care physician and sharing records; restricted EMS role; and shared decision-making. Regression analyses for each theme found that race/ethnicity, public insurance, and patient age were not significantly associated with the level of support. Conclusion: Most caregivers were supportive of alternative EMS disposition options for children with low-acuity complaints. Support did not vary significantly by respondent race/ethnicity, public insurance status, or patient age. |
| first_indexed | 2024-04-11T21:25:28Z |
| format | Article |
| id | doaj.art-058b410b313e489c92f802b3d8ce2c3d |
| institution | Directory Open Access Journal |
| issn | 1936-9018 |
| language | English |
| last_indexed | 2024-04-11T21:25:28Z |
| publishDate | 2022-07-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Western Journal of Emergency Medicine |
| spelling | doaj.art-058b410b313e489c92f802b3d8ce2c3d2022-12-22T04:02:24ZengeScholarship Publishing, University of CaliforniaWestern Journal of Emergency Medicine1936-90182022-07-0123410.5811/westjem.2022.5.55470wjem-23-489Caregiver Perceptions Regarding Alternative Emergency Medical Services Dispositions for Children: A Cross-Sectional Survey AnalysisCaleb E. Ward0Jonathan Gougelet1Ryan Pearman2Gia M. Badolato3Joelle N. Simpson4Division of Emergency Medicine, Children’s National Hospital, Washington, District of ColumbiaThe George Washington University School of Medicine & Health Sciences, Washington, District of ColumbiaDivision of Emergency Medicine, Children’s National Hospital, Washington, District of ColumbiaDivision of Emergency Medicine, Children’s National Hospital, Washington, District of ColumbiaDivision of Emergency Medicine, Children’s National Hospital, Washington, District of ColumbiaIntroduction: Emergency medical services (EMS) systems have developed alternative disposition processes for patients (including leaving the patient at the scene, using taxis, and transporting to clinics) vs taking patients directly to an emergency department (ED). Studies show that patients favorably support these alternative options but have not included the perspectives of caregivers of children. Our objective was to describe caregivers’ views about these alternative disposition processes and analyze whether caregiver support is associated with sociodemographic factors. Methods: We surveyed a convenience sample of caregivers in a pediatric ED. We asked caregivers 15 questions based on a previously validated survey. We then conducted logistic regressions to determine whether sociodemographic factors were associated with levels of support. Results: We enrolled 241 caregivers. The median age of their children was five years. The majority of respondents were non-Hispanic Black (57%) and had public insurance (65%). We found that a majority of respondents supported all alternative EMS disposition options. The overall level of agreement for survey questions ranged from 51–93%. We grouped questions by theme: non-transport; alternative destinations; communication with EMS physician; communication with primary care physician and sharing records; restricted EMS role; and shared decision-making. Regression analyses for each theme found that race/ethnicity, public insurance, and patient age were not significantly associated with the level of support. Conclusion: Most caregivers were supportive of alternative EMS disposition options for children with low-acuity complaints. Support did not vary significantly by respondent race/ethnicity, public insurance status, or patient age.https://escholarship.org/uc/item/896847jd |
| spellingShingle | Caleb E. Ward Jonathan Gougelet Ryan Pearman Gia M. Badolato Joelle N. Simpson Caregiver Perceptions Regarding Alternative Emergency Medical Services Dispositions for Children: A Cross-Sectional Survey Analysis Western Journal of Emergency Medicine |
| title | Caregiver Perceptions Regarding Alternative Emergency Medical Services Dispositions for Children: A Cross-Sectional Survey Analysis |
| title_full | Caregiver Perceptions Regarding Alternative Emergency Medical Services Dispositions for Children: A Cross-Sectional Survey Analysis |
| title_fullStr | Caregiver Perceptions Regarding Alternative Emergency Medical Services Dispositions for Children: A Cross-Sectional Survey Analysis |
| title_full_unstemmed | Caregiver Perceptions Regarding Alternative Emergency Medical Services Dispositions for Children: A Cross-Sectional Survey Analysis |
| title_short | Caregiver Perceptions Regarding Alternative Emergency Medical Services Dispositions for Children: A Cross-Sectional Survey Analysis |
| title_sort | caregiver perceptions regarding alternative emergency medical services dispositions for children a cross sectional survey analysis |
| url | https://escholarship.org/uc/item/896847jd |
| work_keys_str_mv | AT calebeward caregiverperceptionsregardingalternativeemergencymedicalservicesdispositionsforchildrenacrosssectionalsurveyanalysis AT jonathangougelet caregiverperceptionsregardingalternativeemergencymedicalservicesdispositionsforchildrenacrosssectionalsurveyanalysis AT ryanpearman caregiverperceptionsregardingalternativeemergencymedicalservicesdispositionsforchildrenacrosssectionalsurveyanalysis AT giambadolato caregiverperceptionsregardingalternativeemergencymedicalservicesdispositionsforchildrenacrosssectionalsurveyanalysis AT joellensimpson caregiverperceptionsregardingalternativeemergencymedicalservicesdispositionsforchildrenacrosssectionalsurveyanalysis |