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Published on: August 14, 2018
Tertiary Care Referrals for Fractures in Children
Insights
Even minor pediatric surgeries can cause significant family stress and financial strain due to extended hospital stays and missed work. This highlights the burden of accessing specialized pediatric surgical care.
Area of Science:
- Pediatric Surgery
- Healthcare Access
- Family Medicine
Background:
- Limited pediatric subspecialty care access outside urban centers necessitates tertiary hospital referrals.
- Referral-based care for urgent pediatric surgical procedures creates significant burdens for families.
Purpose of the Study:
- To evaluate the financial, organizational, and psychological impact on families of children undergoing brief, urgent surgical procedures at a tertiary care hospital.
Main Methods:
- Prospective survey methodology was employed.
- Families of children (0-18 years) admitted for fracture repair surgery were surveyed.
- Questionnaires assessed various aspects of the family's experience.
Main Results:
- Procedures were often brief (<1 hour), but hospital stays extended up to 36 hours.
- Families experienced significant work absences.
- Prolonged NPO (nothing by mouth) status was noted for many children.
Conclusions:
- Even minor, unexpected pediatric surgeries impose substantial financial, organizational, and psychological burdens on families.
- The study underscores the challenges associated with accessing specialized pediatric surgical care.
Purpose:
With limited local access to pediatric subspecialty care outside major metropolitan areas, tertiary care hospitals treat many children originally seen at outside facilities for relatively brief but urgent surgical procedures. This referral-based care imposes significant financial and psychological stress on the families.
Design:
Prospective, survey methodology was used.
Methods:
Families of children aged 0-18 years admitted to the St. Louis Children's Hospital for surgical repair of fractures were surveyed. The questionnaire was developed by the research team and measured a variety of fields.
Findings:
The operative procedure in the majority of these children was relatively brief in both groups, often less than one hour. The time of injury to their discharge from our hospital, however, extended to 36 hours. Families missed several days of work. Many children were kept NPO longer than needed.
Conclusions:
Our preliminary evaluation suggests that a relatively minor unexpected surgery of a child can impose significant financial, organizational, and psychological burden on the family.
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