Factors associated with ability to treat pediatric emergencies in US hospitals

The purpose of this analysis is to investigate hospital and community factors associated with the availability of pediatric services, expertise, and supplies in US hospitals for treating pediatric emergencies.

Data from the Emergency Pediatric Services and Equipment Supplement, a component of the 2002-2003 National Hospital Ambulatory Medical Care Survey, were merged with hospital and community characteristics to model preparedness to treat pediatric emergencies. The National Hospital Ambulatory Medical Care Survey samples nonfederal, short-stay, and general hospitals in the United States. The Emergency Pediatric Services and Equipment Supplement was based on the 2001 guidelines developed by the American Academy of Pediatrics and the American College of Emergency Physicians. Estimates were weighted to produce unbiased national estimates of pediatric services, expertise, and equipment availability in emergency departments. Logistic regression was used to model the probability of being better prepared based on the above guidelines.

Bivariate analyses showed that hospital inpatient pediatric structure was linearly related to availability of supplies. However, inpatient structure was not associated with presence of a pediatric trauma service or written transfer agreement. Logistic regressions with each preparedness measure indicated that, after adjusting for hospital and community factors, pediatric volume, teaching hospital status, geographic region, and per capita income of the community were strongly related to being better prepared on each of the preparedness measures.

To meet the 2001 guidelines, emergency departments need to improve their inventory of pediatric supplies, and hospitals that do not have specialized inpatient services need to implement written transfer agreements with other hospitals.