Comparing definitions of a pediatric emergency department

Abstract Objective Health services research on the differences in care between pediatric and general emergency departments (EDs) is limited by ambiguity regarding the definition of a pediatric ED. Our goal was to determine the proportion of EDs captured by commonly used definitions of pediatric ED....

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Main Authors: Margaret E. Samuels‐Kalow, Ashley F. Sullivan, Krislyn M. Boggs, Jingya Gao, Elizabeth R. Alpern, Carlos A. Camargo Jr
Format: Article
Language:English
Published: Wiley 2021-06-01
Series:Journal of the American College of Emergency Physicians Open
Subjects:
Online Access:https://doi.org/10.1002/emp2.12478
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author Margaret E. Samuels‐Kalow
Ashley F. Sullivan
Krislyn M. Boggs
Jingya Gao
Elizabeth R. Alpern
Carlos A. Camargo Jr
author_facet Margaret E. Samuels‐Kalow
Ashley F. Sullivan
Krislyn M. Boggs
Jingya Gao
Elizabeth R. Alpern
Carlos A. Camargo Jr
author_sort Margaret E. Samuels‐Kalow
collection DOAJ
description Abstract Objective Health services research on the differences in care between pediatric and general emergency departments (EDs) is limited by ambiguity regarding the definition of a pediatric ED. Our goal was to determine the proportion of EDs captured by commonly used definitions of pediatric ED. Methods We linked data for 2016 from two databases from New York State – the State Emergency Department Database and State Inpatient Database (SEDD/SID) and the National Emergency Department Inventory‐USA (NEDI‐USA). We examined the following 4 common definitions of pediatric ED: (1) admission capability, (2) physically distinct pediatric area in the ED, (3) membership in the Children's Hospital Association, and (4) volume of pediatric ED visits (patients <18 years ). We calculated the proportion of EDs that would be defined as pediatric for each criterion. We also examined the differences in patient demographics among pediatric EDs based on each criterion. Results A total of 160 New York EDs were included in the linked databases. Across the 4 criteria, the proportion of EDs meeting the definition of pediatric ranged from 0% to 86%. Of the EDs, 86% had pediatric admission capability, 27%–38% had a physically distinct pediatric ED, and 8% were members of the Children's Hospital Association. No hospitals met the SEDD/SID criterion of ≥70% visits for patients <18 years. Discussion The number of EDs and characteristics of patients seen varied widely based on the criterion used to define pediatric ED. Database linkage may make it challenging to identify pediatric hospitals in administrative data sets. A valid, standard definition of pediatric ED is critically needed to advance health services research.
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spelling doaj.art-c9234a185c884cada7dcc6ff5614d8d92022-12-21T22:09:46ZengWileyJournal of the American College of Emergency Physicians Open2688-11522021-06-0123n/an/a10.1002/emp2.12478Comparing definitions of a pediatric emergency departmentMargaret E. Samuels‐Kalow0Ashley F. Sullivan1Krislyn M. Boggs2Jingya Gao3Elizabeth R. Alpern4Carlos A. Camargo Jr5Department of Emergency Medicine Massachusetts General Hospital Harvard Medical School Boston Massachusetts USADepartment of Emergency Medicine Massachusetts General Hospital Harvard Medical School Boston Massachusetts USADepartment of Emergency Medicine Massachusetts General Hospital Harvard Medical School Boston Massachusetts USADepartment of Emergency Medicine Massachusetts General Hospital Harvard Medical School Boston Massachusetts USADivision of Emergency Medicine Department of Pediatrics Ann & Robert H. Lurie Children's Hospital Northwestern University Feinberg School of Medicine Chicago Illinois USADepartment of Emergency Medicine Massachusetts General Hospital Harvard Medical School Boston Massachusetts USAAbstract Objective Health services research on the differences in care between pediatric and general emergency departments (EDs) is limited by ambiguity regarding the definition of a pediatric ED. Our goal was to determine the proportion of EDs captured by commonly used definitions of pediatric ED. Methods We linked data for 2016 from two databases from New York State – the State Emergency Department Database and State Inpatient Database (SEDD/SID) and the National Emergency Department Inventory‐USA (NEDI‐USA). We examined the following 4 common definitions of pediatric ED: (1) admission capability, (2) physically distinct pediatric area in the ED, (3) membership in the Children's Hospital Association, and (4) volume of pediatric ED visits (patients <18 years ). We calculated the proportion of EDs that would be defined as pediatric for each criterion. We also examined the differences in patient demographics among pediatric EDs based on each criterion. Results A total of 160 New York EDs were included in the linked databases. Across the 4 criteria, the proportion of EDs meeting the definition of pediatric ranged from 0% to 86%. Of the EDs, 86% had pediatric admission capability, 27%–38% had a physically distinct pediatric ED, and 8% were members of the Children's Hospital Association. No hospitals met the SEDD/SID criterion of ≥70% visits for patients <18 years. Discussion The number of EDs and characteristics of patients seen varied widely based on the criterion used to define pediatric ED. Database linkage may make it challenging to identify pediatric hospitals in administrative data sets. A valid, standard definition of pediatric ED is critically needed to advance health services research.https://doi.org/10.1002/emp2.12478children's hospitalemergency medicinehealth policy
spellingShingle Margaret E. Samuels‐Kalow
Ashley F. Sullivan
Krislyn M. Boggs
Jingya Gao
Elizabeth R. Alpern
Carlos A. Camargo Jr
Comparing definitions of a pediatric emergency department
Journal of the American College of Emergency Physicians Open
children's hospital
emergency medicine
health policy
title Comparing definitions of a pediatric emergency department
title_full Comparing definitions of a pediatric emergency department
title_fullStr Comparing definitions of a pediatric emergency department
title_full_unstemmed Comparing definitions of a pediatric emergency department
title_short Comparing definitions of a pediatric emergency department
title_sort comparing definitions of a pediatric emergency department
topic children's hospital
emergency medicine
health policy
url https://doi.org/10.1002/emp2.12478
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