title: Impact of physicians' characteristics on the admission risk among children visiting a pediatric emergency department.
abstract: OBJECTIVE
  This study aimed to assess the impact of physicians' gender, work experience, and training on hospitalization among children visiting a pediatric emergency department (ED).
  
  
  METHODS
  This retrospective cohort study used the computerized database of a tertiary care pediatric ED staffed by pediatric emergency physicians, general pediatricians, and general emergency physicians. Participants were all children evaluated in the ED between April 1, 2008, and March 31, 2009. The primary outcome was hospitalization, and secondary outcome was unscheduled return in the 48 hours after discharge from the ED. Determinants of outcomes were physician's gender, experience, and specialty training. Multivariate logistic regression was used to evaluate associations between physicians' characteristics and the risk of admission, adjusting for referral status, triage level, chief complaints, and other potential risk factors.
  
  
  RESULTS
  Forty-five physicians evaluated 49,146 patients during the study period. Physicians' individual admission and return rates varied from 1% to 24% and 0% to 11%, respectively. On multiple logistic regression, physician's gender was not a predictor of admission but the physician's years of experience was slightly associated with both admission rates and unscheduled return visits. As a group, pediatric emergency physicians demonstrated a lower admission rate than physicians trained in general pediatric or general emergency medicine.
  
  
  CONCLUSIONS
  Individual physician's admissions proportions vary widely. Providers' experience and specialization in pediatric emergency medicine are weak predictors of admission, whereas gender was not associated.
authors.affiliation: Division of Emergency Medicine, Department of Pediatrics, CHU Sainte-Justine, Université de Montréal, Montréal, Québec, Canada.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Gaucher
authors.forename: Benoit
authors.initials: B
authors.lastname: Bailey
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Gravel
mesh_terms: D000328:Adult; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence / Q000706:statistics & numerical data; D004635:Emergency Medicine; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D058006:General Practice; D006785:Hospitals, University / Q000706:statistics & numerical data; D006786:Hospitals, Urban; D006801:Humans; D007223:Infant; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000706:statistics & numerical data; D010372:Pediatrics; D010820:Physicians / Q000706:statistics & numerical data*; D011792:Quebec; D012189:Retrospective Studies; D012306:Risk; D012737:Sex Factors