TY - JOUR
T1 - Patient- and Community-Level Sociodemographic Characteristics Associated with Emergency Department Visits for Childhood Injury
AU - Macy, Michelle Lea
AU - Zonfrillo, Mark R.
AU - Cook, Lawrence J.
AU - Funai, Tomohiko
AU - Goldstick, Jason
AU - Stanley, Rachel M.
AU - Chamberlain, James M.
AU - Cunningham, Rebecca M.
AU - Lipton, Robert
AU - Alpern, Elizabeth R
N1 - Publisher Copyright:
© 2015 Elsevier Inc.
PY - 2015/9/1
Y1 - 2015/9/1
N2 - Objective To examine pediatric emergency department (ED) visits over 5 years, trends in injury severity, and associations between injury-related ED visit outcome and patient and community-level sociodemographic characteristics. Study design Retrospective analysis of administrative data provided to the Pediatric Emergency Care Applied Research Network Core Data Project, 2004-2008. Home addresses were geocoded to determine census block group and associated sociodemographic characteristics. Maximum Abbreviated Injury Scale severity and Severity Classification System scores were calculated. Generalized estimating equations were used to test for associations between sociodemographic characteristics and admission or transfer among injury-related ED visits. Results Overall ED visits and injury-related visits increased from 2004 to 2008 at study sites. Of 2 833 676 successfully geocoded visits, 700 821 (24.7%) were injury-related. The proportion of higher severity injury-related visits remained consistent. Nearly 10% of injury-related visits resulted in admission or transfer each year. After adjusting for age, sex, payer, and injury severity, odds of admission or transfer were lower among minority children and children from areas with moderate and high prevalence of poverty. Conclusions Pediatric injury-related ED visits to included sites increased over the study period while injury severity, anticipated resource utilization, and visit outcomes remained stable, with low rates of admission or transfer. Sociodemographic differences in injury-related visits and ED disposition were apparent. ED-based injury surveillance is essential to understand disparities, inform targets for prevention programs, and reduce the overall burden of childhood injuries.
AB - Objective To examine pediatric emergency department (ED) visits over 5 years, trends in injury severity, and associations between injury-related ED visit outcome and patient and community-level sociodemographic characteristics. Study design Retrospective analysis of administrative data provided to the Pediatric Emergency Care Applied Research Network Core Data Project, 2004-2008. Home addresses were geocoded to determine census block group and associated sociodemographic characteristics. Maximum Abbreviated Injury Scale severity and Severity Classification System scores were calculated. Generalized estimating equations were used to test for associations between sociodemographic characteristics and admission or transfer among injury-related ED visits. Results Overall ED visits and injury-related visits increased from 2004 to 2008 at study sites. Of 2 833 676 successfully geocoded visits, 700 821 (24.7%) were injury-related. The proportion of higher severity injury-related visits remained consistent. Nearly 10% of injury-related visits resulted in admission or transfer each year. After adjusting for age, sex, payer, and injury severity, odds of admission or transfer were lower among minority children and children from areas with moderate and high prevalence of poverty. Conclusions Pediatric injury-related ED visits to included sites increased over the study period while injury severity, anticipated resource utilization, and visit outcomes remained stable, with low rates of admission or transfer. Sociodemographic differences in injury-related visits and ED disposition were apparent. ED-based injury surveillance is essential to understand disparities, inform targets for prevention programs, and reduce the overall burden of childhood injuries.
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U2 - 10.1016/j.jpeds.2015.05.047
DO - 10.1016/j.jpeds.2015.05.047
M3 - Article
C2 - 26141551
AN - SCOPUS:84940453590
VL - 167
SP - 711-718.e4
JO - Journal of Pediatrics
JF - Journal of Pediatrics
SN - 0022-3476
IS - 3
ER -