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Fall injuries in the pediatric population: safer and most cost-effective management
S B Pillai1, C A Bethel, G E Besner
1Division of Pediatric Surgery, The Ohio State University, Columbus, USA.
Insights
Pediatric falls result in significant delays and costs due to unnecessary evaluations at local hospitals. Immediate transfer and avoiding routine X-rays before transfer can improve care for children with fall injuries.
Area of Science:
- Pediatric Trauma Care
- Health Services Research
Background:
- Falls constitute 30% of trauma admissions at children's hospitals.
- Inefficiencies and costs in pediatric fall patient care were investigated.
Purpose of the Study:
- To identify inefficiencies in the care of pediatric fall patients.
- To quantify unnecessary costs associated with pediatric fall admissions.
Main Methods:
- Retrospective chart review of 127 children admitted for falls (height >= 9 feet) between 1993-1996.
- Analysis of patient demographics, injuries, and treatment costs.
Main Results:
- 45% of children were evaluated at an outside facility before transfer.
- Pre-transfer evaluations caused an average treatment delay of 4.5 hours.
- Duplicated radiographic studies, often normal, incurred significant costs.
Conclusions:
- Immediate transfer of pediatric fall patients with significant injuries is recommended.
- Omission of pre-transfer radiographs and avoidance of routine X-rays can improve cost-effectiveness.
- Streamlined care pathways can enhance outcomes for pediatric fall patients.
Background:
At our children's hospital, 30% of all trauma admissions are from falls. The aim of this study was to outline inefficiencies and unnecessary costs incurred in the care of these patients.
Methods:
The charts of 127 children admitted for falls (height > or = 9 feet) from 1993 to 1996 were reviewed. Patient demographics, injuries, and treatment costs were recorded and analyzed.
Results:
Fifty-seven children (45%) were evaluated at an outside facility before transfer. Of these, 73% had injuries requiring treatment at the pediatric center. Local hospital work-up resulted in an average treatment delay of 4.5 hours. Additionally, significant cost was incurred by duplication of radiographic studies, the majority of which were normal.
Conclusion:
Improved and more cost-effective care in pediatric falls can be ensured by immediate transfer of patients with significant injuries, omission of radiographs before transfer, and avoidance of multiple routine x-ray films, the majority of which are normal.
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