Comparisons between Full-time and Part-time Pediatric Emergency Physicians in Pediatric Emergency Department
| Autor: | Shao-Hsuan Hsia, Tang-Her Jaing, Pao-Lan Tuan, Hui-Hsuan Wang, Chang-Teng Wu, Minston Chao, Hsiang-Ju Hsiao, Yu-Ching Chang, I-Anne Huang |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Quality management Multivariate analysis Adolescent Full-time physicians Personnel Staffing and Scheduling Taiwan Pilot Projects emergency departments 03 medical and health sciences 0302 clinical medicine children length of stay quality of health care Pediatric emergency medicine 030225 pediatrics Odds Ratio Humans Medicine Pediatrics Perinatology and Child Health Child Retrospective Studies Pediatric Emergency Medicine business.industry Mortality rate Medical record Infant Newborn lcsh:RJ1-570 Infant lcsh:Pediatrics 030208 emergency & critical care medicine Retrospective cohort study Odds ratio medicine.disease Hospitalization Child Preschool Pediatrics Perinatology and Child Health Emergency medicine Female Medical emergency Emergency Service Hospital business |
| Zdroj: | Pediatrics and Neonatology, Vol 57, Iss 5, Pp 371-377 (2016) |
| ISSN: | 1875-9572 |
| DOI: | 10.1016/j.pedneo.2015.10.005 |
| Popis: | Background Pediatric emergency medicine is a young field that has established itself in recent decades. Many unanswered questions remain regarding how to deliver better pediatric emergency care. The implementation of full-time pediatric emergency physicians is a quality improvement strategy for child care in Taiwan. The aim of this study is to evaluate the quality of care under different physician coverage models in the pediatric emergency department (ED). Methods The medical records of 132,398 patients visiting the pediatric ED of a tertiary care university hospital during January 2004 to December 2006 were retrospectively reviewed. Full-time pediatric emergency physicians are the group specializing in the pediatric emergency medicine, and they only work in the pediatric ED. Part-time pediatricians specializing in other subspecialties also can work an extra shift in the pediatric ED, with the majority working in their inpatient and outpatient services. We compared quality performance indicators, including: mortality rate, the 72-hour return visit rate, length of stay, admission rate, and the rate of being kept for observation between full-time and part-time pediatric emergency physicians. Results An average of 3678 ± 125 [mean ± standard error (SE)] visits per month (with a range of 2487–6646) were observed. The trends in quality of care, observed monthly, indicated that the 72-hour return rate was 2–6% and length of stay in the ED decreased from 11.5 hours to 3.2 hours over the study period. The annual mortality rate within 48 hours of admission to the ED increased from 0.04% to 0.05% and then decreased to 0.02%, and the overall mortality rate dropped from 0.13% to 0.07%. Multivariate analyses indicated that there was no change in the 72-hour return visit rate for full-time pediatric emergency physicians; they were more likely to admit and keep patients for observation [odds ratio = 1.43 and odds ratio = 1.71, respectively], and these results were similar to those of senior physicians. Conclusion Full-time pediatric emergency physicians in the pediatric ED decreased the mortality rate and length of stay in the ED, but had no change in the 72-hour return visit rate. This pilot study shows that the quality of care in pediatric ED after the implementation of full-time pediatric emergency physicians needs further evaluation. |
| Databáze: | OpenAIRE |
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