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Access to High Pediatric-Readiness Emergency Care in the United States

Kristin N Ray1, Lenora M Olson2, Elizabeth A Edgerton3

  • 1Department of Pediatrics, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh, Pittsburgh, PA.

The Journal of Pediatrics
|January 17, 2018
PubMed

Insights

Many US children lack access to high-readiness emergency departments (EDs). Only 33.7% can reach a top-tier ED within 30 minutes, highlighting disparities in pediatric emergency care access.

Area of Science:

  • Pediatric Emergency Medicine
  • Health Services Research
  • Geographic Accessibility Studies

Background:

  • Timely access to emergency departments (EDs) is crucial for pediatric care.
  • Pediatric readiness, defined by specific guidelines, impacts the quality of emergency care for children.
  • Assessing geographic accessibility to highly prepared EDs is essential for public health planning.

Purpose of the Study:

  • To evaluate the geographic accessibility of US children to emergency departments (EDs) demonstrating high pediatric readiness.
  • To determine the percentage of the US child population within a 30-minute drive of a highly pediatric-ready ED.

Main Methods:

  • Cross-sectional analysis of geographic access to EDs based on pediatric readiness.
  • Utilized the weighted pediatric readiness score (WPRS) from the 2013 National Pediatric Readiness Project (NPRP) survey.
  • Calculated drive times from ZIP code centroids to EDs with varying WPRS thresholds.

Main Results:

  • Only 33.7% of US children can reach an ED with a maximum WPRS (100) within 30 minutes.
  • 55.3% and 70.2% of children have access to EDs at or above the 90th and 75th percentile WPRS, respectively.
  • Significant regional disparities exist, with access ranging from 14.9% to 56.2% across census divisions for top-tier EDs.

Conclusions:

  • A substantial portion of US children lack timely access to emergency departments with optimal pediatric readiness.
  • Findings underscore the need for strategies to improve geographic and equitable access to high-quality pediatric emergency care.
  • Disparities in access highlight critical areas for targeted public health interventions and resource allocation.
Abstract

Keywords:
accessemergency departmentgeographic accesspediatric-ready

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