Variation in hospital admission of sickle cell patients from the emergency department using the Pediatric Health Information System
| Autor: | William E. Bennett, Aaron E. Carroll, Anneli R. Cochrane, Emily L. Mueller, Seethal A. Jacob |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Fever Names of the days of the week Population Pain Disease Anemia Sickle Cell Article 03 medical and health sciences Health Information Systems Young Adult 0302 clinical medicine International Classification of Diseases Statistical significance Acute care Medicine Humans education Child Retrospective Studies education.field_of_study Univariate analysis Newborn screening business.industry Infant Newborn Infant Hematology Emergency department Prognosis Hospitalization Oncology 030220 oncology & carcinogenesis Child Preschool Pediatrics Perinatology and Child Health Emergency medicine Female business Emergency Service Hospital 030215 immunology Follow-Up Studies |
| Zdroj: | Pediatr Blood Cancer |
| ISSN: | 1545-5017 |
| Popis: | Background Universal newborn screening and improved treatment options have led to increased survival in sickle cell disease (SCD). However, patients with SCD still rely heavily on acute care services. Objective To determine the variation seen in hospitalizations for the top complaints for ED visits for children with SCD nationally. Methods We performed a retrospective review of the Pediatric Health Information Systems (PHIS) Database between October 2011 and September 2015. Emergency department (ED) encounters were selected by using International Classification of Diseases, Ninth Edition, Clinical Modification (ICD-9-CM) codes for SCD with and without crisis, fever, and pain. Univariate analyses were performed, as well as index of dispersion (ID) to assess variation by day of the week and region. ANOVA and t-test were used to determine statistical significance. Results A total of 68 661 ED encounters at 36 hospitals met the criteria for inclusion. Of those encounters, 50.1% were admitted to the hospital. Pain and fever were the most common primary diagnoses among this population. Although variation in hospitalization was seen overall, as well as for a primary diagnosis of pain or fever, this variation was not explained by weekday/weekend designation. Conclusion The results of our study confirm pain and fever as the most common primary diagnoses for children with SCD who seek acute care, as well as demonstrate that while significant variation in hospitalization exists, it is not associated with day of the week. Further studies to elucidate patient- and hospital-level factors that influence admission variation are necessary. |
| Databáze: | OpenAIRE |
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