ArticleAcademic pediatrics2018
Hospital and Community Characteristics Associated With Pediatric Direct Admission to Hospital.
Article in Academic pediatrics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
4 citing papers in PubMed.
- Uses of Health Care System Medical Care Services by Athletes After Injury at the High School Level.The Journal of school health · 2023Article
- Evaluation of the American Hospital Association Annual Survey for health services research in emergency medicine.Journal of the American College of Emergency Physicians open · 2022Article
- Comparing definitions of a pediatric emergency department.Journal of the American College of Emergency Physicians open · 2021Article
- Consolidating Emergency Department-specific Data to Enable Linkage with Large Administrative Datasets.The western journal of emergency medicine · 2020Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
objectivesOne quarter of pediatric hospitalizations begin as direct admissions, defined as hospitalization without receiving care in the hospital's emergency department (ED). Direct admission rates are highly variable across hospitals, yet previous studies have not examined reasons for this variation. We aimed to determine the relationships between hospital and community factors and pediatric direct admission rates, and to evaluate the degree to which these characteristics explain variation in risk-adjusted direct admission rates.
methodsWe conducted a cross-sectional study of the Healthcare Cost and Utilization Project's Kids Inpatient Database, American Hospital Association Database, and Area Health Resource File, including children <18 years of age who were admitted for a medical hospitalization in states contributing data to all data sets. Using hierarchical generalized linear modeling, we generated risk-adjusted direct admission rates and used generalized linear models to assess the association of hospital and community characteristics with these risk-adjusted rates.
resultsWe included 211,458 children discharged from 933 hospitals and 26 states; 20.2% were admitted directly. One-fifth of the variance in risk-adjusted direct admission rates was attributed to observed hospital and community factors. The greatest proportion of this explained variance was related to ED volume (37%), volume of pediatric hospitalizations (27%), and size of the pediatrician workforce (12%).
conclusionsDirect admission rates were associated with several hospital and community characteristics, but the majority of variation in hospitals' direct admission rates was not explained by these factors. These findings suggest opportunities for diverse hospital types to develop the infrastructure and communication systems necessary to support pediatric direct admissions.
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