ArticlePloS one2019
Multistate model of the patient flow process in the pediatric emergency department.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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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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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
4 citing papers in PubMed.
- Evaluating the transitions in care for children presenting with acute asthma to emergency departments: a retrospective cohort study.BMC emergency medicine · 2021Article
- The influence of occupational class and physical workload on working life expectancy among older employees.Scandinavian journal of work, environment & health · 2021Article
- Type of facility influences lengths of stay of children presenting to high volume emergency departments.BMC pediatrics · 2020Article
- Frequent users of emergency departments and patient flow in Alberta and Ontario, Canada: an administrative data study.BMC health services research · 2020Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
objectivesThe main purpose of this paper was to model the process by which patients enter the ED, are seen by physicians, and discharged from the Emergency Department at Nationwide Children's Hospital, as well as identify modifiable factors that are associated with ED lengths of stay through use of multistate modeling.
methodsIn this study, 75,591 patients admitted to the ED from March 1st, 2016 to February 28th, 2017 were analyzed using a multistate model of the ED process. Cox proportional hazards models with transition-specific covariates were used to model each transition in the multistate model and the Aalen-Johansen estimator was used to obtain transition probabilities and state occupation probabilities in the ED process.
resultsAcuity level, season, time of day and number of ED physicians had significant and varying associations with the six transitions in the multistate model. Race and ethnicity were significantly associated with transition to left without being seen, but not with the other transitions. Conversely, age and gender were significantly associated with registration to room and subsequent transitions in the model, though the magnitude of association was not strong.
conclusionsThe multistate model presented in this paper decomposes the overall ED length of stay into constituent transitions for modeling covariate-specific effects on each transition. This allows physicians to understand the ED process and identify which potentially modifiable covariates would have the greatest impact on reducing the waiting times in each state in the model.
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Registered trials
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