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Emergency care for children in the United States

James M Chamberlain, Steven Krug, Kathy N Shaw

    Health Affairs (Project Hope)
    |December 5, 2013
    PubMed

    Insights

    Pediatric emergency care in the US has advanced but still faces challenges like overcrowding and inconsistent quality. Policy changes are needed to improve care access and reimbursement for children

    Area of Science:

    • Pediatric Emergency Medicine
    • Healthcare Systems Analysis
    • Health Policy

    Background:

    • Formal pediatric emergency care systems emerged in the 1980s with specialized training.
    • Regional networks and research consortia have since been established.
    • Despite progress, significant challenges persist in pediatric emergency departments (EDs).

    Purpose of the Study:

    • To review the evolution and current state of pediatric emergency care in the US.
    • To identify persistent challenges and areas for improvement.
    • To advocate for policy changes to enhance pediatric emergency services.

    Main Methods:

    • Review of historical development of pediatric emergency care.
    • Analysis of common and specific issues within pediatric emergency departments.
    • Identification of systemic problems including access, quality, and resources.

    Main Results:

    • Pediatric emergency care has developed specialized training and research infrastructure.
    • Persistent issues include ED overcrowding, variable quality, low-volume ED challenges, and mental health resource gaps.
    • Lack of standardized performance metrics hinders progress.

    Conclusions:

    • Pediatric emergency care requires policy interventions to address systemic issues.
    • Recommendations include expanding after-hours care options and reforming payment structures.
    • Policy reform is crucial for equitable and effective pediatric emergency services.

    Keywords:
    Children’s HealthOrganization And Delivery Of CareQuality Of CareSafety-Net SystemsVariations

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