Fall injuries in the pediatric population: safer and most cost-effective management.
BACKGROUND
At our children's hospital, 30% of all trauma admissions are from falls. The aim of this study was to outline inefficiencies and unnecessary costs incurred in the care of these patients.


METHODS
The charts of 127 children admitted for falls (height > or = 9 feet) from 1993 to 1996 were reviewed. Patient demographics, injuries, and treatment costs were recorded and analyzed.


RESULTS
Fifty-seven children (45%) were evaluated at an outside facility before transfer. Of these, 73% had injuries requiring treatment at the pediatric center. Local hospital work-up resulted in an average treatment delay of 4.5 hours. Additionally, significant cost was incurred by duplication of radiographic studies, the majority of which were normal.


CONCLUSIONS
Improved and more cost-effective care in pediatric falls can be ensured by immediate transfer of patients with significant injuries, omission of radiographs before transfer, and avoidance of multiple routine x-ray films, the majority of which are normal.
Pillai
S B
SB
Division of Pediatric Surgery, The Ohio State University, Columbus, USA.
Bethel
C A
CA
Besner
G E
GE
Caniano
D A
DA
Cooney
D R
DR
D000058:Accidental Falls / Q000191:economics* / Q000706:statistics & numerical data; D000704:Analysis of Variance; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis / Q000706:statistics & numerical data; D006259:Craniocerebral Trauma / Q000000981:diagnostic imaging / Q000191:economics; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data; D006801:Humans; D015601:Injury Severity Score; D010360:Patient Transfer / Q000191:economics; D011859:Radiography / Q000191:economics*; D014193:Trauma Centers / Q000706:statistics & numerical data; D014947:Wounds and Injuries / Q000191:economics / Q000209:etiology / Q000628:therapy*