Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #104779

John Pascoe, MD, MPH¹, Adrienne Stolfi, MSPH¹, Arthur Pickoff, MD¹, Carla Clasen, RN/MPH², and Katherine Cauley, PhD². (1) Department of Pediatrics, Wright State University, Children's Medical Center, One Children's Plaza, Dayton, OH 45404, 937-641-3277, john.pascoe@wright.edu, (2) Center for Healthy Communities, Wright State University, 140 East Monument Avenue, Dayton, OH 45402

METHOD: The Emergency Department(ED) Profiling Algorithm created at the New York(NY)University Center for Health and Public Service Research was applied to all administrative records for children less than 19 years old who were seen at The Children's Medical Center(CMC)of Dayton's ED between 1987 and 2003. The four algorithm(AL) categories included: Non-Emergent(NE), Emergent/Primary Care Treatable(EPCT), Emergent/ED Care Needed, but Preventable(EP) and Emergent/ED Care Needed, Not Preventable(ENP). For each diagnosis a specific proportion of patients was assigned to each of the four categories by a panel of ED physician "experts", thus the sum of proportions for each diagnosis equals 1.0. AL proportions are based on reviews of 5700 ED records from six NY hospitals in 1994/95. RESULTS: 461,796 visits "mapped" to the AL. The most common diagnoses: otitis media(64,199), asthma(42,306), acute URI(40,692). The overall mean+/-SD for each of the AL's four categories for 17 years of ED visits were: NE .35+/-.27,EPCT .36+/-.25, EP .17+/-.31, ENP .12+/-.21. Following the 1997 State Child Health Insurance Plan the proportion of NE visits decreased .25(1997), .26(1998), .30(1999). Since 2000 the proportion of NE visits have ranged from .37 to .45. CONCLUSION: Children with common primary care diagnoses have been seen at the CMC's ED for many years. Improving access to primary care services is a vitally important component of any strategy that aims to provide high quality, cost-effective health care for children in the 21st century.

Learning Objectives:

• To describe the number of children treated for emergent, not preventable and non-emergent conditions over 17 years at The Children's Medical Center of Dayton using a validated algorithm

Keywords: Children and Adolescents, Emergency Department/Room

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Handout (.ppt format,