Variation in hospital admission from the emergency department for children with cancer: A Pediatric Health Information System study
| Autor: | William E. Bennett, Aaron E. Carroll, Anneli R. Cochrane, Seethal A. Jacob, Emily L. Mueller |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Neutropenia Adolescent Fever Names of the days of the week Article 03 medical and health sciences Health Information Systems Young Adult 0302 clinical medicine International Classification of Diseases Neoplasms Medicine Humans Child Retrospective Studies Univariate analysis business.industry Infant Newborn Cancer Infant Retrospective cohort study Hematology Emergency department medicine.disease Prognosis Hospitalization Oncology 030220 oncology & carcinogenesis Child Preschool Pediatrics Perinatology and Child Health Emergency medicine Female Outcomes research business Emergency Service Hospital Febrile neutropenia 030215 immunology Follow-Up Studies |
| Zdroj: | Pediatr Blood Cancer |
| ISSN: | 1545-5017 |
| Popis: | Background Children with cancer experience a wide range of conditions that require urgent evaluation in the emergency department (ED), yet variation in admission rates is poorly documented. Procedure We performed a retrospective cohort study using the Pediatric Health Information System of ED encounters by children with cancer between July 2012 and June 2015. We compared demographics for admitted versus discharged using univariate statistics, and calculated admission rates by hospital, diagnosis, day of the week, and weekend versus weekday. We assessed the degree of interhospital admission rates using the index of dispersion (ID). Results Children with cancer had 60 054 ED encounters at 37 hospitals. Overall, 62.5% were admitted (range 43.2%-92.1%, ID 2.6) indicating overdispersed admission rates with high variability. Children with cancer that visited the ED for a primary diagnosis of fever experienced the largest amount of variability in admission with rates ranging from 10.4% to 74.1% (ID 8.1). Less variability existed among hospital admission rates for both neutropenia (range 60%-100%, ID 1.0) and febrile neutropenia (FN) (range 66.7%-100%, ID 0.83). Admission rates by day of the week did not demonstrate significant variability for any of the scenarios examined (overall P = 0.91). There were no differences by weekend versus weekday either (overall P = 0.52). Conclusion The percentage of children with cancer admitted through the ED varies widely by institution and diagnosis. Standardization of best practices for children with cancer admitted through the ED should be an area of continued improvement. |
| Databáze: | OpenAIRE |
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