Inari Listo1, Heli Salmi2, Matti Hästbacka3, Mitja Lääperi3, Jelena Oulasvirta4, Tiina Etelälahti3, Markku Kuisma3, Heini Harve-Rytsälä3. 1. Division of Anesthesiology, Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, P.O. Box 340, Helsinki, FI-00029, HUS, Finland; New Children's Hospital, University of Helsinki and Helsinki University Hospital, P.O. Box 347, Helsinki, FI-00029, HUS, Finland. Electronic address: inari.listo@hus.fi. 2. Division of Anesthesiology, Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, P.O. Box 340, Helsinki, FI-00029, HUS, Finland; New Children's Hospital, University of Helsinki and Helsinki University Hospital, P.O. Box 347, Helsinki, FI-00029, HUS, Finland. 3. Emergency Medicine and Services, University of Helsinki and Helsinki University Hospital, P.O. Box 340, Helsinki, FI-00029, HUS, Finland. 4. Division of Anesthesiology, Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, P.O. Box 340, Helsinki, FI-00029, HUS, Finland.
Abstract
BACKGROUND: Identifying pediatric populations at risk for traumas would enable development of emergency medical services and emergency departments for children. Elucidation of the nature of socioeconomic differences in the incidence of pediatric out-of-hospital emergencies is needed to overcome inequities in child health. METHODS: We retrieved all ambulance contacts during 17.12.2014-16.12.2018 involving children (0-15 years) in Helsinki, Finland and separated traumatic and nontraumatic emergencies. We compared the incidences of these emergencies in the pediatric population with socioeconomic markers of the scene of the emergency and of the residential area of the child. RESULTS: Of 11,742 ambulance contacts involving children 4113 (35.0%) were traumatic. Traumatic emergencies occurred more often in neighborhoods with lower median income/household (P=0.043) and were more common in children living in areas with lower median income/inhabitant (P=0.001), higher unemployment (P<0.001), and lower education (P<0.001). The associations were weaker for traumatic than nontraumatic emergencies. Higher proportion of a pediatric population in a residential area (P=0.005) had a protective effect. Exclusion of clinically unnecessary ambulance responses did not change the results. CONCLUSION: Traumatic emergencies in children are more common in areas with lower socioeconomic status. The possible protective effect of urban planning merits further studies. TYPE OF STUDY: Prognostic. LEVEL OF EVIDENCE: II.
BACKGROUND: Identifying pediatric populations at risk for traumas would enable development of emergency medical services and emergency departments for children. Elucidation of the nature of socioeconomic differences in the incidence of pediatric out-of-hospital emergencies is needed to overcome inequities in child health. METHODS: We retrieved all ambulance contacts during 17.12.2014-16.12.2018 involving children (0-15 years) in Helsinki, Finland and separated traumatic and nontraumatic emergencies. We compared the incidences of these emergencies in the pediatric population with socioeconomic markers of the scene of the emergency and of the residential area of the child. RESULTS: Of 11,742 ambulance contacts involving children 4113 (35.0%) were traumatic. Traumatic emergencies occurred more often in neighborhoods with lower median income/household (P=0.043) and were more common in children living in areas with lower median income/inhabitant (P=0.001), higher unemployment (P<0.001), and lower education (P<0.001). The associations were weaker for traumatic than nontraumatic emergencies. Higher proportion of a pediatric population in a residential area (P=0.005) had a protective effect. Exclusion of clinically unnecessary ambulance responses did not change the results. CONCLUSION:Traumatic emergencies in children are more common in areas with lower socioeconomic status. The possible protective effect of urban planning merits further studies. TYPE OF STUDY: Prognostic. LEVEL OF EVIDENCE: II.
Authors: Jelena Oulasvirta; Jussi Pirneskoski; Heini Harve-Rytsälä; Mitja Lääperi; Mikael Kuitunen; Markku Kuisma; Heli Salmi Journal: BMJ Paediatr Open Date: 2020-11-02
Authors: Johannes Björkman; Päivi Laukkanen-Nevala; Anna Olkinuora; Ilkka Pulkkinen; Jouni Nurmi Journal: BMJ Open Date: 2021-02-23 Impact factor: 2.692