Ability of hospitals to care for pediatric emergency patients.
BACKGROUND
The needs of children in emergency situations differ from those of adults and require special attention, yet there has been no study of the ability of U.S. hospitals to care for emergently or critically ill children.


OBJECTIVE
To estimate the distribution of pediatric services available at U.S. hospitals with emergency departments (EDs).


METHODS
Self-report survey of 101 hospital EDs.


METHODS
Stratified probability sample of all U.S. hospitals operating EDs.


RESULTS
The majority of hospitals that usually admit pediatric patients do not have separate pediatric facilities. Hospitals without a pediatric department, ward, or trauma service usually transfer critically injured pediatric trauma patients; however, nearly 10% of hospitals without pediatric intensive care facilities admit critically injured children to their own facilities. Likewise, 7% of hospitals routinely admit pediatric patients known to require intensive care to their adult intensive care units rather than transferring the patient to a facility with pediatric intensive care facilities. Few hospitals have protocols for obtaining pediatric consultation on pediatric emergencies. Appropriately sized equipment for successful care of infants and children in an emergency situation was more likely to be missing than adult-sized equipment, and significant numbers of hospitals did not have adequate equipment to care for newborn emergencies.


CONCLUSIONS
Emergent and critical care of infants and children may not be well integrated and regionalized within our health care system, suggesting that there is room for improvement in the quality of care for children encountering emergent illness and trauma.
Athey
J
J
Health Policy Resources Group, LLC, Brookeville, MD 20833-2233, USA. jathey@hprg.com
Dean
J M
JM
Ball
J
J
Wiebe
R
R
Melese-d'Hospital
I
I
D000328:Adult; D002648:Child; D002673:Child, Hospitalized; D003422:Critical Care / Q000458:organization & administration; D003625:Data Collection; D004636:Emergency Service, Hospital / Q000458:organization & administration* / Q000592:standards; D004638:Emergency Treatment / Q000592:standards*; D004865:Equipment and Supplies, Hospital / Q000592:standards; D006757:Hospital Units; D006769:Hospitals, General / Q000458:organization & administration / Q000592:standards*; D006801:Humans; D007231:Infant, Newborn; D010343:Patient Admission; D010360:Patient Transfer; D010372:Pediatrics / Q000458:organization & administration*; D011787:Quality of Health Care; D014481:United States