Cost-Effectiveness And Health Impact Of Increasing Emergency Department Pediatric Readiness In The US

Area of Science:

• Health Services Research
• Pediatric Emergency Medicine
• Health Economics

Background:

• Emergency department (ED) care quality for children in the US is inconsistent.
• The National Pediatric Readiness Project seeks to improve pediatric emergency care outcomes.
• Variability in ED readiness impacts pediatric patient survival rates.

Purpose of the Study:

• To conduct a cost-effectiveness analysis of enhancing pediatric readiness in US emergency departments.
• To quantify the health and economic impact of improving ED pediatric readiness.
• To determine the cost-effectiveness of achieving high pediatric readiness nationally.

Main Methods:

• A decision-analytic simulation model was utilized.
• Data from a nationally representative cohort of 747 EDs across eleven states were used for clinical and cost parameters.
• Lifetime costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs) were calculated from a healthcare sector perspective with a 3% discount rate.
• Probabilistic, one-way, and subgroup sensitivity analyses were performed.

Main Results:

• Increasing ED pediatric readiness yielded 69,100 QALYs for the eleven-state cohort at an ICER of $9,300 per QALY gained.
• Achieving high pediatric readiness nationally is projected to yield 179,000 QALYs at the same ICER, with estimated implementation costs of $260 million.
• Sensitivity analyses confirmed the robustness of the findings.

Conclusions:

• Implementing high ED pediatric readiness across all US EDs is a highly cost-effective strategy.
• Improving pediatric readiness in emergency departments offers significant improvements in child survival and quality of life.
• Investment in national pediatric readiness is recommended to enhance emergency care for children.