Children’s Health Care in Mass-Casualty Incidents: A Systematic Literature Review

Author(s):  
Victor S.L.P. Costa ◽  
Giovanna M. Stéfani ◽  
Helio A. Ferenhof ◽  
Fabiana S. Lima ◽  
Maíra Cola

Abstract Objectives: Considering the pediatric peculiarities and the difficulty of assisting this population in mass-casualty situations, this study aims to identify the main topics regarding children’s health care in mass-casualty incidents (MCIs) that are discussed in the Emergency Medicine area. Methods: This systematic review was performed according to the recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and registered with the PROSPERO database of systematic reviews with the number CRD42021229552. The last update of the search in the databases was on May 27, 2021 and resulted in 45 documents to be analyzed. The inclusion criteria included the peer-reviewed academic papers in English, Portuguese, Spanish, and Italian languages; the databases used were PubMed, Scopus, MEDLINE/Bireme (Virtual Library of Health - VLH), and Web of Science, which execute the query on the topic, keywords, or abstracts. Also, to be included, documents that were available with full-text access through CAPES, Google, or Google Scholar. Books, non-academic research, and content in languages other than the presented ones were represented as exclusion criteria. Results: From the resulting papers, 21 articles served as the basis for this analysis. Revealed were the year of publication, the first author’s institution nationality, topic, and disaster management phase for each study, which allow other researchers to understand the main topics regarding children’s health care in MCIs. Conclusions: The topics regarding child’s health care in MCIs found in the primary studies of this review, in order of frequency, were: Disaster Response (including the following sub-topics: simulation, education, quality of care, use of technological tools, and damage analysis); Triage; and Disaster Planning. The Emergency Medicine operation was focused on harm reduction after the occurrence of an MCI. Further studies focusing on the pre-disaster and post-disaster phases are needed.

2018 ◽  
Vol 172 (6) ◽  
pp. 513 ◽  
Author(s):  
Charlene A. Wong ◽  
James M. Perrin ◽  
Mark McClellan

PEDIATRICS ◽  
2000 ◽  
Vol 106 (Supplement_E1) ◽  
pp. 1256-1270 ◽  
Author(s):  
M. Douglas Jones ◽  
Thomas Boat ◽  
Robert Adler ◽  
Harlan R. Gephart ◽  
Lucy M. Osborn ◽  
...  

Some of the challenges of financing pediatric medical education are shared with all medical education; others are specific to pediatrics. The general disadvantage that funding of graduate medical education (GME) is linked to reimbursement for clinical care has uniquely negative consequences for freestanding children's hospitals because they therefore receive little Medicare GME support. This represents both a competitive disadvantage for such hospitals and an aggregate federal underinvestment in children's health care that now amounts to billions of dollars. The need to subsidize medical student and subspecialty education with clinical practice revenue jeopardizes both activities in pediatric departments already burdened by inadequate reimbursement for children's health care and the extra costs of ambulatory care. The challenges of funding are complicated by rising costs as curriculum expands and clinical education moves to ambulatory settings. Controversies over prioritization of resources are inevitable. Solutions require specification of costs of education and a durable mechanism for building consensus within the pediatric community. Pediatrics2000;106(suppl):1256–1269; medical student education, continuing medical education, medical subspecialties, children, pediatrics, health maintenance organizations, managed care, hospital finances, children's hospitals.


2019 ◽  
Vol 18 ◽  
pp. 160940691983511
Author(s):  
Lauri Litovuo ◽  
Nina Karisalmi ◽  
Leena Aarikka-Stenroos ◽  
Johanna Kaipio

Interest in studying experiences has grown rapidly; however, little attention has been paid to the applicability of qualitative methods for capturing the service experience in children’s health care. This study examined and compared three data collection methods to capture the multidimensional service experience of child patients and their families: video diaries with child patients, narrative interviews with parents of a child patient, and semistructured interviews with health-care professionals working with child patients. The methods were analyzed with respect to their benefits and limitations and their applicability for capturing the multidimensional service experience presented by service experience co-creation framework, including the temporal, factual, spatial, locus, control, and organizational dimensions. The key findings are as follows: (A) The video diary method has the potential to capture the temporally broad and spatially complex phenomenon of child patients’ service experience and enables researchers to capture service experience created beyond the hospital setting (e.g., through hobbies or in school). (B) Narratives with parents have the potential to capture the temporal, spatial, locus, and organizational dimensions through stories and are well-suited for mapping children’s experiences and the actors influencing them. (C) Semistructured interviews with health-care professionals have the potential to capture a generalized but temporally narrow view of the service experience of child patients, concentrating on experiences within hospital settings. This is beneficial for developing health-care service providers’ actions. Structured analysis and comparison of methods guides researchers to select appropriate methods to take a complementary approach in the understanding of experiences in the context of children’s health care.


2015 ◽  
Vol 06 (01) ◽  
pp. 110-119 ◽  
Author(s):  
L.E. Costello ◽  
A. Gebremariam ◽  
K.J. Dombkowski ◽  
S.J. Clark

SummaryObjectives: To assess parents’ current utilization and future willingness to use patient portals to interact with their child’s health care provider.Methods: A cross-sectional survey of a nationally representative sample of US parents was conducted using an established online panel. Bivariate analyses assessed associations between current utilization and future willingness to use patient portals, parental concerns, and demographic variables.Results: Among the 1,420 parent respondents, 40% did not know whether their child’s health practice offers the option of setting up a patient portal for their child. Of the 21% of parents who reported being offered the option of setting up a patient portal for their child, 59% had done so. Among parents who had the option but chose not to set up a patient portal for their child, lack of time and low perceived need were the main reasons cited. Current use and likelihood of future use was highest for viewing lab results and immunization records. The most common concern about patient portals was the security of the child portal system.Conclusions: Current use of patient portals by parents is low. Only about half of parents currently using or likely to use a portal perceive value in using portals for certain tasks, which suggests that providers will need to continue traditional communication mechanisms to reach their entire patient population.Citation: Clark SJ, Costello LE, Gebremariam A, Dombkowski KJ. A national survey of parent perspectives on use of patient portals for children’s health care. Appl Clin Inf 2015; 6: 110–119http://dx.doi.org/10.4338/ACI-2014-10-RA-0098


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