Access to High Pediatric-Readiness Emergency Care in the United States - 13/01/18
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Abstract |
Objective |
To determine the geographic accessibility of emergency departments (EDs) with high pediatric readiness by assessing the percentage of US children living within a 30-minute drive time of an ED with high pediatric readiness, as defined by collaboratively developed published guidelines.
Study design |
In this cross-sectional analysis, we examined geographic access to an ED with high pediatric readiness among US children. Pediatric readiness was assessed using the weighted pediatric readiness score (WPRS) of US hospitals based on the 2013 National Pediatric Readiness Project (NPRP) survey. A WPRS of 100 indicates that the ED meets the essential guidelines for pediatric readiness. Using estimated drive time from ZIP code centroids, we determined the proportions of US children living within a 30-minute drive time of an ED with a WPRS of 100 (maximum), 94.3 (90th percentile), and 83.6 (75th percentile).
Results |
Although 93.7% of children could travel to any ED within 30 minutes, only 33.7% of children could travel to an ED with a WPRS of 100, 55.3% could travel to an ED with a WPRS at or above the 90th percentile, and 70.2% could travel to an ED with a WPRS at or above the 75th percentile. Among children within a 30-minute drive of an ED with the maximum WPRS, 90.9% lived closer to at least 1 alternative ED with a WPRS below the maximum. Access varied across census divisions, ranging from 14.9% of children in the East South Center to 56.2% in the Mid-Atlantic for EDs scoring a maximum WPRS.
Conclusion |
A significant proportion of US children do not have timely access to EDs with high pediatric readiness.
Le texte complet de cet article est disponible en PDF.Keywords : access, geographic access, emergency department, pediatric-ready
Abbreviations : AHA, ED, EMSC, GIS, ICU, NPRP, WPRS
Plan
Supported in part by grants from the US Agency for Healthcare Research and Quality (K12HS022989, to K.R.), the Children's Hospital of Pittsburgh of the UPMC Health System (to K.R.), the US National Institutes of Health (K08 HL122478 , to D.W.), and the US Department of Health and Human Services Health Resources and Services Administration (U03MC00008, to E.E.; HSAMC24076, to J.K.; U07MC09174, to L.O.; and U07MCO5036, to L.O.). The authors declare no conflicts of interest. |
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