title: Effectiveness of a five-level Paediatric Triage System: an analysis of resource utilisation in the emergency department in Taiwan.
abstract: OBJECTIVE
  To examine the effectiveness of a five-level Paediatric Triage and Acuity System (Ped-TTAS) by comparing the reliability of patient prioritisation and resource utilisation with the four-level Paediatric Taiwan Triage System (Ped-TTS) among non-trauma paediatric patients in the emergency department (ED).
  
  
  METHODS
  The study design used was a retrospective longitudinal analysis based on medical chart review and a computer database. Except for a shorter list of complaints and some abnormal vital sign criteria modifications, the structure and triage process for applying Ped-TTAS was similar to that of the Paediatric Canadian Emergency Triage and Acuity Scale. Non-trauma paediatric patients presenting to the ED were triaged by well-trained triage nurses using the four-level Ped-TTS in 2008 and five-level Ped-TTAS in 2010. Hospitalisation rates and medical resource utilisation were analysed by acuity levels between the contrasting study groups.
  
  
  RESULTS
  There was a significant difference in patient prioritisation between the four-level Ped-TTS and five-level Ped-TTAS. Improved differentiation was observed with the five-level Ped-TTAS in predicting hospitalisation rates and medical costs.
  
  
  CONCLUSIONS
  The five-level Ped-TTAS is better able to discriminate paediatric patients by triage acuity in the ED and is also more precise in predicting resource utilisation. The introduction of a more accurate acuity and triage system for use in paediatric emergency care should provide greater patient safety and more timely utilisation of appropriate ED resources.
authors.affiliation: Department of Emergency Medicine, Chang Gung Memorial Hospital Linkou and College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.
authors.forename: Yu-Che
authors.initials: YC
authors.lastname: Chang
authors.forename: Chip-Jin
authors.initials: CJ
authors.lastname: Ng
authors.forename: Chang-Teng
authors.initials: CT
authors.lastname: Wu
authors.forename: Li-Chin
authors.initials: LC
authors.lastname: Chen
authors.forename: Jih-Chang
authors.initials: JC
authors.lastname: Chen
authors.forename: Kuang-Hung
authors.initials: KH
authors.lastname: Hsu
mesh_terms: D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007902:Length of Stay / Q000706:statistics & numerical data; D008137:Longitudinal Studies; D008297:Male; D012189:Retrospective Studies; D013624:Taiwan; D014218:Triage / Q000379:methods*