OBJECTIVE: To investigate differences in the quality of emergency care for children related to differences in hospital setting, physician training, and demographic factors. STUDY DESIGN: This was a retrospective cohort study of a consecutive sample of children presenting with high-acuity illnesses or injuries at 4 rural non-children's hospitals (RNCHs) and 1 academic urban children's hospital (UCH). Two of 4 study physicians independently rated quality of care using a validated implicit review instrument. Hierarchical modeling was used to estimate quality of care (scored from 5 to 35) across hospital settings and by physician training. RESULTS: A total of 304 patients presenting to the RNCHs and the UCH were studied. Quality was lower (difference = -3.23; 95% confidence interval [CI] = -4.48 to -1.98) at the RNCHs compared with the UCH. Pediatric emergency medicine (PEM) physicians provided better care than family medicine (FM) physicians and those in the "other" category (difference = -3.34, 95% CI = -5.40 to -1.27 and -3.12, 95% CI = -5.25 to -0.99, respectively). Quality of care did not differ significantly between PEM and general emergency medicine (GEM) physicians in general, or between GEM and PEM physicians at the UCH; however, GEM physicians at the RNCHs provided care of lesser quality than PEM physicians at the UCH (difference = -2.75; 95% CI = -5.40 to -0.05). Older children received better care. CONCLUSIONS: The quality of care provided to children is associated with age, hospital setting, and physician training.
OBJECTIVE: To investigate differences in the quality of emergency care for children related to differences in hospital setting, physician training, and demographic factors. STUDY DESIGN: This was a retrospective cohort study of a consecutive sample of children presenting with high-acuity illnesses or injuries at 4 rural non-children's hospitals (RNCHs) and 1 academic urban children's hospital (UCH). Two of 4 study physicians independently rated quality of care using a validated implicit review instrument. Hierarchical modeling was used to estimate quality of care (scored from 5 to 35) across hospital settings and by physician training. RESULTS: A total of 304 patients presenting to the RNCHs and the UCH were studied. Quality was lower (difference = -3.23; 95% confidence interval [CI] = -4.48 to -1.98) at the RNCHs compared with the UCH. Pediatric emergency medicine (PEM) physicians provided better care than family medicine (FM) physicians and those in the "other" category (difference = -3.34, 95% CI = -5.40 to -1.27 and -3.12, 95% CI = -5.25 to -0.99, respectively). Quality of care did not differ significantly between PEM and general emergency medicine (GEM) physicians in general, or between GEM and PEM physicians at the UCH; however, GEM physicians at the RNCHs provided care of lesser quality than PEM physicians at the UCH (difference = -2.75; 95% CI = -5.40 to -0.05). Older children received better care. CONCLUSIONS: The quality of care provided to children is associated with age, hospital setting, and physician training.
Authors: Nicole M Poole; Daniel J Shapiro; Katherine E Fleming-Dutra; Lauri A Hicks; Adam L Hersh; Matthew P Kronman Journal: Pediatrics Date: 2019-01-08 Impact factor: 7.124
Authors: Stefanie G Ames; Billie S Davis; Jennifer R Marin; Ericka L Fink; Lenora M Olson; Marianne Gausche-Hill; Jeremy M Kahn Journal: Pediatrics Date: 2019-09 Impact factor: 7.124
Authors: James P Marcin; Patrick S Romano; Madan Dharmar; James M Chamberlain; Nanette Dudley; Charles G Macias; Lise E Nigrovic; Elizabeth C Powell; Alexander J Rogers; Meridith Sonnett; Leah Tzimenatos; Elizabeth R Alpern; Rebecca Andrews-Dickert; Dominic A Borgialli; Erika Sidney; Charlie Casper; Jonathan Michael Dean; Nathan Kuppermann Journal: Health Serv Res Date: 2017-11-16 Impact factor: 3.402
Authors: Tiffani J Johnson; Monika K Goyal; Scott A Lorch; James M Chamberlain; Lalit Bajaj; Evaline A Alessandrini; Timothy Simmons; T Charles Casper; Cody S Olsen; Robert W Grundmeier; Elizabeth R Alpern Journal: Pediatr Emerg Care Date: 2022-02-01 Impact factor: 1.602
Authors: Manuel Rocha Melo; Manuel Ferreira-Magalhães; Filipa Flor-Lima; Mariana Rodrigues; Milton Severo; Luis Almeida-Santos; Alberto Caldas-Afonso; Pedro Pita Barros; António Ferreira Journal: PLoS One Date: 2016-08-26 Impact factor: 3.240