Comparing Pediatric Gastroenteritis Emergency Department Care in Canada and the United States
| Autor: | Adam C. Levine, Elizabeth C. Powell, Robert E. Sapien, Ken J. Farion, Stephen B. Freedman, Suzanne Schuh, Katrina F. Hurley, John M. VanBuren, Prashant Mahajan, Cheryl Vance, David Schnadower, Seema Bhatt, Karen J. O'Connell, Naveen Poonai, Jesse G. Norris, Alexander J. Rogers, Cindy G. Roskind, Serge Gouin, Phillip I. Tarr |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Canada 03 medical and health sciences 0302 clinical medicine 030225 pediatrics Acute care Severity of illness Health care medicine Humans business.industry Infant Emergency department Odds ratio Articles Ondansetron United States Confidence interval Gastroenteritis Hospitalization Diarrhea Child Preschool Pediatrics Perinatology and Child Health Emergency medicine Cohort Female medicine.symptom Emergency Service Hospital business |
| Zdroj: | Pediatrics Paediatrics Publications |
| Popis: | BACKGROUND: Between-country variation in health care resource use and its impact on outcomes in acute care settings have been challenging to disentangle from illness severity by using administrative data. METHODS: We conducted a preplanned analysis employing patient-level emergency department (ED) data from children enrolled in 2 previously conducted clinical trials. Participants aged 3 to RESULTS: In adjusted analysis, unscheduled revisits within 7 days did not differ (adjusted odds ratio [aOR]: 0.72; 95% confidence interval (CI): 0.50 to 1.02). At the index ED visit, although participants in Canada were assessed as being more dehydrated, intravenous fluids were administered more frequently in the United States (aOR: 4.6; 95% CI: 2.9 to 7.1). Intravenous fluid administration rates did not differ after enrollment (aOR: 1.4; 95% CI: 0.7 to 2.8; US cohort with Canadian as referent). Overall, intravenous rehydration was higher in the United States (aOR: 3.8; 95% CI: 2.5 to 5.7). Although hospitalization rates during the 7 days after enrollment (aOR: 1.1; 95% CI: 0.4 to 2.6) did not differ, hospitalization at the index visit was more common in the United States (3.9% vs 2.3%; aOR: 3.2; 95% CI: 1.6 to 6.8). CONCLUSIONS: Among children with gastroenteritis and similar disease severity, revisit rates were similar in our 2 study cohorts, despite lower rates of intravenous rehydration and hospitalization in Canadian-based EDs. |
| Databáze: | OpenAIRE |
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