scholarly journals Epinephrine autoinjector prescription filling after pediatric emergency department discharge

2021 ◽  
Vol 42 (2) ◽  
pp. 142-146
Author(s):  
Joanna S. Cohen ◽  
Chisom Agbim ◽  
Michael Hrdy ◽  
Mary E. Mottla ◽  
Monika K. Goyal ◽  
...  
Keyword(s):  
Emergency Department ◽  
Private Insurance ◽  
Sociodemographic Factors ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
Factors Associated ◽  
Outpatient Prescription ◽  
Significant Difference ◽  
Bivariable Analysis ◽  
Emergency Department Discharge

Background: There are known racial and socioeconomic disparities in the use of epinephrine autoinjectors (EAI) for anaphylaxis. Objective: To measure the rates of EAI prescription filling and identify patient demographic factors associated with filling rates among patients discharged from the pediatric emergency department. Methods: This was a retrospective observational cohort study of all patients discharged from a pediatric emergency department who received an outpatient prescription for an EAI between January 1, 2018, and October 31, 2019. The rates of prescription filling were calculated, and multivariable logistic regression was performed to identify sociodemographic factors associated with prescription filling. Results: Of 717 patients included in the analysis, 54.8% (95% confidence interval {CI}, 51.1%‐58.5%) filled their prescription. There were no significant associations between EAI fill rates and patient age or sex. In bivariable analysis, non-Hispanic white patients were more likely to fill EAI prescriptions compared with non-Hispanic Black patients (odds ratio [OR] 1.89 [95% CI, 1.11‐3.20]), and patients with in-state Medicaid were significantly less likely to fill EAI prescriptions compared with those patients with private insurance (OR 0.69 [95% CI, 0.48‐0.98]). However, after multivariable adjustment, there was no significant difference in filling by age, insurance status, or race or ethnicity. Conclusions: Only approximately half the patients had their EAI prescriptions filled after discharge. Filling rates did not vary by sociodemographic characteristics.

Sociodemographic Factors Associated With Adherence to Referrals From the Pediatric Emergency Department

2020 ◽  
Vol 58 (4) ◽  
pp. 594-602
Author(s):  
Benjamin A. Palleiko ◽  
Jeremy V. Lynn ◽  
Angie H. Achkar ◽  
Tamera Hart-Johnson ◽  
Marcia A. Perry ◽  
...  
Keyword(s):  
Emergency Department ◽  
Sociodemographic Factors ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
Factors Associated

Factors Associated With Medication Errors in the Pediatric Emergency Department

2011 ◽  
Vol 27 (4) ◽  
pp. 290-294 ◽  
Author(s):  
Mònica Vilà-de-Muga ◽  
Laura Colom-Ferrer ◽  
Mariona Gonzàlez-Herrero ◽  
Carles Luaces-Cubells
Keyword(s):  
Emergency Department ◽  
Medication Errors ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
Factors Associated

scholarly journals The appropriateness of referrals to a pediatric emergency department via a telephone health line

CJEM ◽  
2009 ◽  
Vol 11 (02) ◽  
pp. 139-148 ◽  
Author(s):  
Tawfik Al-Abdullah ◽  
Amy C. Plint ◽  
Alyson Shaw ◽  
Rhonda Correll ◽  
Isabelle Gaboury ◽  
...  
Keyword(s):  
Emergency Department ◽  
Resource Use ◽  
Primary Outcome ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
Lengths Of Stay ◽  
Triage Category ◽  
Significant Difference ◽  
Secondary Outcomes ◽  
Explicit Criteria

ABSTRACT Objective: We compared the appropriateness of visits to a pediatric emergency department (ED) by provincial telephone health line–referral, by self- or parent-referral, and by physician-referral. Methods: A cohort of patients younger than 18 years of age who presented to a pediatric ED during any of four 1-week study periods were prospectively enrolled. The cohort consisted of all patients who were referred to the ED by a provincial telephone health line or by a physician. For each patient referred by the health line, the next patient who was self- or parent-referred was also enrolled. The primary outcome was visit appropriateness, which was determined using previously published explicit criteria. Secondary outcomes included the treating physician's view of appropriateness, disposition (hospital admission or discharge), treatment, investigations and the length of stay in the ED. Results: Of the 578 patients who were enrolled, 129 were referred from the health line, 102 were either self- or parent-referred, and 347 were physician-referred. Groups were similar at baseline for sex, but health line–referred patients were significantly younger. Using explicitly set criteria, there was no significant difference in visit appropriateness among the health line–referrals (66%), the self- or parent-referrals (77%) and the physician-referrals (73%) (p = 0.11). However, when the examining physician determined visit appropriateness, physician-referred patients (80%) were deemed appropriate significantly more often than those referred by the health line (56%, p < 0.001) or by self- or parent-referral (63%, p = 0.002). There was no significant difference between these latter 2 referral routes (p = 0.50). In keeping with their greater acuity, physician-referred patients were significantly more likely to have investigations, receive some treatment, be admitted to hospital and have longer lengths of stay. Patients who were self- or parent-referred, and those who were health line–referred were similar to each other in these outcomes. Conclusion: There was no significant difference in visit appropriateness based on the route of referral when we used set criteria; however, there was when we used treating physician opinion, triage category and resource use.

Factors Associated With Pediatric Burn Clinic Follow-up After Emergency Department Discharge

2021 ◽  
Author(s):  
Paige L Seegan ◽  
Kavya Tangella ◽  
Nicholas P Seivert ◽  
Elizabeth Reynolds ◽  
Andrea S Young ◽  
...  
Keyword(s):  
Emergency Department ◽  
Sociodemographic Factors ◽  
Burn Patients ◽  
Targeted Interventions ◽  
Factors Associated ◽  
Patient Gender ◽  
Race Ethnicity ◽  
Emergency Department Discharge ◽  
Improve Health

Abstract Attrition between emergency department discharge and outpatient follow-up is well documented across a variety of pediatric ailments. Given the importance of outpatient medical care and the lack of related research in pediatric burn populations, we examined sociodemographic factors and burn characteristics associated with outpatient follow-up adherence among pediatric burn patients. A retrospective review of medical records was conducted on patient data extracted from a burn registry database at an urban academic children’s hospital over a 2-year period (January 2018–December 2019). All patients were treated in the emergency department and discharged with instructions to follow-up in an outpatient burn clinic within 1 week. A total of 196 patients (Mage = 5.5 years; 54% male) were included in analyses. Average % TBSA was 1.9 (SD = 1.5%). One third of pediatric burn patients (33%) did not attend outpatient follow-up as instructed. Older patients (odds ratio [OR] = 1.00; 95% confidence interval [CI]: [0.99–1.00], P = .045), patients with superficial burns (OR = 9.37; 95% CI: [2.50–35.16], P = .001), patients with smaller % TBSA (OR = 1.37; 95% CI: [1.07–1.76], P = .014), and patients with Medicaid insurance (OR = 0.22; 95% CI: [0.09–0.57], P = .002) or uninsured/unknown insurance (OR = 0.07; 95% CI: [0.02–0.26], P = .000) were less likely to follow up, respectively. Patient gender, race, ethnicity, and distance to clinic were not associated with follow-up. Follow-up attrition in our sample suggests a need for additional research identifying factors associated with adherence to follow-up care. Identifying factors associated with follow-up adherence is an essential step in developing targeted interventions to improve health outcomes in this at-risk population.

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