Epidemiology of a pediatric emergency medicine research network: the PECARN Core Data Project.
OBJECTIVE
To examine the epidemiology of pediatric patient visits to emergency departments (ED).


METHODS
We conducted a cross-sectional study of pediatric ED visits at the participating Pediatric Emergency Care Applied Research Network (PECARN) hospitals in 2002. We provide descriptive characteristics of pediatric ED visits and a comparison of the study database to the National Hospital Ambulatory Medical Care Survey (NHAMCS). Bivariate analyses were calculated to assess characteristics associated with hospital admission, death in the ED, and length of ED visit. We also performed multivariate regression to model the likelihood of admission to the hospital.


RESULTS
Mean patient age was 6.2 years; 53.5% were boys; 47.5% black; and 43.2% had Medicaid insurance. The most common ED diagnoses were fever, upper respiratory infection, asthma, otitis media, and viral syndromes. The inpatient admission rate was 11.6%. The most common diagnoses requiring hospitalization were asthma, dehydration, fever, bronchiolitis, and pneumonia. In multivariate analysis, patients who were black or Hispanic, had Medicaid insurance or were uninsured, or were older than 1 year were less likely to be hospitalized. Demographics of the PECARN population were similar to NHAMCS, with notable exceptions of a larger proportion of black patients and of admitted patients from the PECARN EDs.


CONCLUSIONS
We describe previously unavailable epidemiological information about childhood illnesses and injuries that can inform development of future studies on the effectiveness, outcomes, and quality of emergency medical services for children. Most pediatric ED patients in our study sought care for infectious causes or asthma and were discharged from the ED. Hospital admission rate differed according to age, payer type, race/ethnicity, and diagnosis.
Alpern
Elizabeth R
ER
Department of Pediatrics, Division of Emergency Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA. alpern@email.chop.edu
Stanley
Rachel M
RM
Gorelick
Marc H
MH
Donaldson
Amy
A
Knight
Stacey
S
Teach
Stephen J
SJ
Singh
Tasmeen
T
Mahajan
Prashant
P
Goepp
Julius G
JG
Kuppermann
Nathan
N
Dean
J Michael
JM
Chamberlain
James M
JM
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003710:Demography; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data; D010372:Pediatrics / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology