Cost of a learner in pediatric ED

Area of Science:

• Medical Education
• Health Services Research
• Pediatric Emergency Medicine

Background:

• Experiential learning is crucial in medical education.
• Resident involvement can affect patient throughput, resource utilization, and outcomes.
• Understanding these impacts is vital for optimizing healthcare delivery.

Purpose of the Study:

• To quantify the impact of residents on patient throughput, resource utilization, and outcomes.
• To analyze these effects across different patient complexity levels.
• To determine the cost-effectiveness of resident physicians in an urban tertiary care pediatric emergency department.

Main Methods:

• Retrospective study of 33,278 patient encounters in 2016.
• Comparison of throughput, utilization, and patient outcome measures between resident-covered and non-resident-covered patients.
• Subgroup analysis based on patient complexity using CPT codes.

Main Results:

• Resident involvement was associated with unfavorable throughput, utilization, and patient experience measures overall.
• Throughput measures were unfavorable or trending unfavorably for residents across all patient complexities.
• Utilization and outcome measures were unfavorable for residents in low/moderate complexity cases but similar in high complexity cases.

Conclusions:

• Residents' presence initially increases throughput and utilization metrics.
• These negative impacts lessen with increasing patient complexity.
• The cost-effectiveness of residents may improve in managing higher complexity patients.