Assessment of Inadequate Use of Pediatric Emergency Medical Transport Services: The Pediatric Emergency and Ambulance Critical Evaluation (PEACE) Study
Aim: To provide data on the inadequate use of emergency medical transports services (EMTS) in children and underlying contributing factors.Methods: This was a prospective single-center cohort study (01/2017-12/2017) performed at the Saarland University Children's Hospital, Homburg, Germany. Pat...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2019-10-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fped.2019.00442/full |
| _version_ | 1818552996847419392 |
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| author | Martin Poryo Martin Burger Stefan Wagenpfeil Bennet Ziegler Harald Sauer Marina Flotats-Bastardas Ulrich Grundmann Michael Zemlin Sascha Meyer |
| author_facet | Martin Poryo Martin Burger Stefan Wagenpfeil Bennet Ziegler Harald Sauer Marina Flotats-Bastardas Ulrich Grundmann Michael Zemlin Sascha Meyer |
| author_sort | Martin Poryo |
| collection | DOAJ |
| description | Aim: To provide data on the inadequate use of emergency medical transports services (EMTS) in children and underlying contributing factors.Methods: This was a prospective single-center cohort study (01/2017-12/2017) performed at the Saarland University Children's Hospital, Homburg, Germany. Patients ≤20 years of age transported by EMTS for suspected acute illness/trauma were included and proportion of inadequate/adequate EMTS use, underlying contributing factors, and additional costs were analyzed.Results: Three hundred seventy-nine patients (mean age: 9.0 ± 6.3 years; 55.7% male, 44.3% female) were included in this study. The three most common reasons for EMTS use were: central nervous system (30.6%), respiratory system affection (14.0%), and traumas (13.2%). ETMS use was categorized as inadequate depending on physician's experience: senior physician (58.8%), pediatrician (54.9%), resident (52.7%). All three physicians considered 127 (33.5%) cases to be medically indicated for transportation by EMTS, and 177 (46.7%) to be medically not indicated. The following parameters were significantly associated with inadequate EMTS use: non-acute onset of symptoms (OR 2.5), parental perception as non-life-threatening (OR 1.7), and subsequent out-patient treatment (OR 4.0). Conversely, transport by an emergency physician (OR 3.5) and first time parental EMTS call (OR 1.7) were associated with adequate use of EMTS. Moreover, a significant relation existed between maternal, respectively, paternal educational status and inadequate EMTS use (each p = 0.01). Using multiple logistic regression analysis, non-acute onset of symptoms (OR 2.2) was associated with inadequate use of EMTS while first time parental EMTS call (OR 1.8), transport by an emergency physician (OR 3.3), and need for in-patient treatment (OR 4.0) were associated with adequate use of EMTS.Conclusion: A substantial number of pediatric EMTS is medically not indicated. Possibly, specific measures including multifaceted educational efforts may be helpful in reducing unnecessary EMTS use. |
| first_indexed | 2024-12-12T09:20:19Z |
| format | Article |
| id | doaj.art-f75a54378d6242c0a055757dbe43d6a1 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-12-12T09:20:19Z |
| publishDate | 2019-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-f75a54378d6242c0a055757dbe43d6a12022-12-22T00:29:15ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602019-10-01710.3389/fped.2019.00442463080Assessment of Inadequate Use of Pediatric Emergency Medical Transport Services: The Pediatric Emergency and Ambulance Critical Evaluation (PEACE) StudyMartin Poryo0Martin Burger1Stefan Wagenpfeil2Bennet Ziegler3Harald Sauer4Marina Flotats-Bastardas5Ulrich Grundmann6Michael Zemlin7Sascha Meyer8Department of Pediatric Cardiology, Saarland University Medical Center, Homburg, GermanyMedical School, University of Saarland, Homburg, GermanyInstitute for Medical Biometry, Epidemiology and Medical Informatics, Saarland University Medical Center, Homburg, GermanySPG, Saarpfalz-Gymnasium, Homburg, GermanyDepartment of Pediatric Cardiology, Saarland University Medical Center, Homburg, GermanyDepartment of Neuropediatrics, Saarland University Medical Center, Homburg, GermanyDepartment of Anesthesiology, Intensive Care and Pain Therapy, Saarland University Medical Center, Homburg, GermanyDepartment of Pediatrics and Neonatology, Saarland University Medical Center, Homburg, GermanyDepartment of Pediatrics and Neonatology, Saarland University Medical Center, Homburg, GermanyAim: To provide data on the inadequate use of emergency medical transports services (EMTS) in children and underlying contributing factors.Methods: This was a prospective single-center cohort study (01/2017-12/2017) performed at the Saarland University Children's Hospital, Homburg, Germany. Patients ≤20 years of age transported by EMTS for suspected acute illness/trauma were included and proportion of inadequate/adequate EMTS use, underlying contributing factors, and additional costs were analyzed.Results: Three hundred seventy-nine patients (mean age: 9.0 ± 6.3 years; 55.7% male, 44.3% female) were included in this study. The three most common reasons for EMTS use were: central nervous system (30.6%), respiratory system affection (14.0%), and traumas (13.2%). ETMS use was categorized as inadequate depending on physician's experience: senior physician (58.8%), pediatrician (54.9%), resident (52.7%). All three physicians considered 127 (33.5%) cases to be medically indicated for transportation by EMTS, and 177 (46.7%) to be medically not indicated. The following parameters were significantly associated with inadequate EMTS use: non-acute onset of symptoms (OR 2.5), parental perception as non-life-threatening (OR 1.7), and subsequent out-patient treatment (OR 4.0). Conversely, transport by an emergency physician (OR 3.5) and first time parental EMTS call (OR 1.7) were associated with adequate use of EMTS. Moreover, a significant relation existed between maternal, respectively, paternal educational status and inadequate EMTS use (each p = 0.01). Using multiple logistic regression analysis, non-acute onset of symptoms (OR 2.2) was associated with inadequate use of EMTS while first time parental EMTS call (OR 1.8), transport by an emergency physician (OR 3.3), and need for in-patient treatment (OR 4.0) were associated with adequate use of EMTS.Conclusion: A substantial number of pediatric EMTS is medically not indicated. Possibly, specific measures including multifaceted educational efforts may be helpful in reducing unnecessary EMTS use.https://www.frontiersin.org/article/10.3389/fped.2019.00442/fullambulanceemergency medical transport servicemisusepediatric emergencypublic health |
| spellingShingle | Martin Poryo Martin Burger Stefan Wagenpfeil Bennet Ziegler Harald Sauer Marina Flotats-Bastardas Ulrich Grundmann Michael Zemlin Sascha Meyer Assessment of Inadequate Use of Pediatric Emergency Medical Transport Services: The Pediatric Emergency and Ambulance Critical Evaluation (PEACE) Study Frontiers in Pediatrics ambulance emergency medical transport service misuse pediatric emergency public health |
| title | Assessment of Inadequate Use of Pediatric Emergency Medical Transport Services: The Pediatric Emergency and Ambulance Critical Evaluation (PEACE) Study |
| title_full | Assessment of Inadequate Use of Pediatric Emergency Medical Transport Services: The Pediatric Emergency and Ambulance Critical Evaluation (PEACE) Study |
| title_fullStr | Assessment of Inadequate Use of Pediatric Emergency Medical Transport Services: The Pediatric Emergency and Ambulance Critical Evaluation (PEACE) Study |
| title_full_unstemmed | Assessment of Inadequate Use of Pediatric Emergency Medical Transport Services: The Pediatric Emergency and Ambulance Critical Evaluation (PEACE) Study |
| title_short | Assessment of Inadequate Use of Pediatric Emergency Medical Transport Services: The Pediatric Emergency and Ambulance Critical Evaluation (PEACE) Study |
| title_sort | assessment of inadequate use of pediatric emergency medical transport services the pediatric emergency and ambulance critical evaluation peace study |
| topic | ambulance emergency medical transport service misuse pediatric emergency public health |
| url | https://www.frontiersin.org/article/10.3389/fped.2019.00442/full |
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