Acute healthcare utilization by children after motor vehicle crashes
Flaura K Winston1, Michael R Elliott, Irene G Chen
1The Center for Clinical Epidemiology and Biostatistics, The University of Pennsylvania, Blockley Hall, Room 818, 423 Guardian Drive, Philadelphia, PA 19104, USA. Flaura@mail.upenn.edu
Insights
Child crash victims often don't receive medical care. Accurate tracking of child injuries from motor vehicle crashes requires including emergency departments and physician's offices.
Area of Science:
- Pediatric trauma
- Public health surveillance
- Healthcare utilization
Background:
- Motor vehicle crashes are a significant cause of injury in children.
- Existing surveillance systems may underestimate the healthcare burden of pediatric crash injuries.
- Accurate data on child crash victims' healthcare needs is crucial for resource allocation.
Purpose of the Study:
- To describe acute healthcare resource utilization among children (15 years and younger) involved in motor vehicle crashes.
- To identify patterns of care received by child crash victims.
- To inform the development of comprehensive child-specific crash surveillance systems.
Main Methods:
- Utilized data from Partners for Child Passenger Safety, a large-scale, child-specific crash surveillance system.
- Included insurance claims from 15 states and the District of Columbia.
- Employed a probability sample of 4862 crashes involving 7368 child occupants, with data from telephone surveys and on-site investigations.
Main Results:
- For every 1000 children in crashes, 3 were hospitalized.
- 108 children per 1000 were treated and released from an emergency department (ED).
- 48 children per 1000 received evaluation in a physician's office or other facility, while 841 received no care.
Conclusions:
- A significant proportion of child crash victims do not receive formal medical evaluation or treatment.
- Current healthcare resource utilization estimates may be incomplete without including non-hospital care.
- Comprehensive surveillance must capture care provided in emergency departments, physician offices, and other facilities to accurately assess motor vehicle trauma impact.
Abstract:
This study, describing the overall patterns of acute healthcare resource utilization by child crash victims (age 15 years and younger), was conducted between 28 July 1999 and 30 November 2000 as part of an on-going large-scale, child-specific crash surveillance system, Partners for Child Passenger Safety: insurance claims from 15 states and the District of Columbia function as the source of subjects, with telephone survey and on-site crash investigations serving as the primary sources of data. A probability sample of 4862 eligible crashes with 7368 child occupants formed the study sample. Our results suggest that for every 1000 children involved in crashes, 3 are hospitalized; 108 are treated and released from an emergency department (ED); 48 are evaluated in a physician's office, urgent care center, or other facility; and 841 receive no care at all. Comprehensive surveillance systems for motor vehicle crashes must capture children treated in physicians' offices, emergency departments, and other healthcare facilities in order to provide accurate estimates of the impact on the health care system related to motor vehicle trauma.
