Resource Burden at Children's Hospitals Experiencing Surge Volumes During the Spring 2009 H1N1 Influenza Pandemic

被引：22

作者：

Sills, Marion R. ^{[1
,2
]}

Hall, Matthew ^{[3
]}

Simon, Harold K. ^{[4
,5
]}

Fieldston, Evan S. ^{[6
,7
]}

Walter, Nicholas ^{[8
]}

Levin, James E. ^{[9
]}

Brogan, Thomas V. ^{[10
,11
]}

Hain, Paul D. ^{[12
]}

Goodman, Denise M. ^{[13
,14
]}

Fritch-Levens, D. D. ^{[15
]}

Fagbuyi, Daniel B. ^{[16
,17
]}

Mundorff, Michael B. ^{[18
]}

Libby, Anne M. ^{[19
]}

Anderson, Heather O. ^{[20
]}

Padula, William V. ^{[21
]}

Shah, Samir S. ^{[22
,23
]}

机构：

[1] Univ Colorado, Dept Pediat, Sch Med, Aurora, CO USA

[2] Childrens Hosp, Sect Emergency Med, Aurora, CO USA

[3] Child Hlth Corp Amer, Shawnee Mission, KS USA

[4] Emory Univ, Sch Med, Dept Pediat, Atlanta, GA USA

[5] Emory Univ, Sch Med, Dept Emergency Med, Atlanta, GA USA

[6] Univ Penn, Sch Med, Dept Pediat, Philadelphia, PA 19104 USA

[7] Childrens Hosp Philadelphia, Div Gen Pediat, Philadelphia, PA 19104 USA

[8] Univ Colorado, Sch Med, Dept Med, Div Pulm Sci & Crit Care Med, Aurora, CO USA

[9] UPMC, Childrens Hosp Pittsburgh, Pittsburgh, PA USA

[10] Univ Washington, Sch Med, Div Crit Care Med, Seattle Childrens Hosp, Seattle, WA USA

[11] Univ Washington, Sch Med, Dept Pediat, Seattle, WA 98195 USA

[12] Monroe Carell Jr Childrens Hosp Vanderbilt, Nashville, TN USA

[13] Northwestern Univ, Childrens Mem Hosp, Div Crit Care Med, Chicago, IL 60614 USA

[14] Northwestern Univ, Dept Pediat, Chicago, IL 60611 USA

[15] Childrens Hlth Care Atlanta, Emergency Serv, Atlanta, GA USA

[16] George Washington Univ, Sch Med, Dept Pediat, Washington, DC 20052 USA

[17] Childrens Natl Med Ctr, Div Emergency Med, Washington, DC 20010 USA

[18] Primary Childrens Med Ctr, Syst Improvement Dept, Salt Lake City, UT 84103 USA

[19] Univ Colorado, Sch Pharm, Aurora, CO USA

[20] Colorado Sch Publ Hlth, Dept Epidemiol, Aurora, CO USA

[21] Univ Colorado, Denver & Hlth Sci Ctr, Pharmaceut Outcomes Res Program, Aurora, CO USA

[22] Univ Penn, Sch Med, Dept Pediat, Div Infect Dis,Childrens Hosp Philadelphia, Philadelphia, PA 19104 USA

[23] Univ Penn, Sch Med, Dept Biostat & Epidemiol, Div Infect Dis,Childrens Hosp Philadelphia, Philadelphia, PA 19104 USA

来源：

ACADEMIC EMERGENCY MEDICINE | 2011年 / 18卷 / 02期

关键词：

PEDIATRIC EMERGENCY-DEPARTMENT; NEW-YORK-CITY; SEASONAL INFLUENZA; A H1N1; SCIENCE; HOSPITALIZATIONS; INFANTS; A(H1N1); CARE;

D O I：

10.1111/j.1553-2712.2010.00992.x

中图分类号：

R4 [临床医学];

学科分类号：

100218 [急诊医学];

摘要：

Objectives: The objective was to describe the emergency department (ED) resource burden of the spring 2009 H1N1 influenza pandemic at U. S. children's hospitals by quantifying observed-to-expected utilization. ,Methods: The authors performed an ecologic analysis for April through July 2009 using data from 23 EDs in the Pediatric Health Information System (PHIS), an administrative database of widely distributed U. S. children's hospitals. All ED visits during the study period were included, and data from the 5 prior years were used for establishing expected values. Primary outcome measures included observed-to-expected ratios for ED visits for all reasons and for influenza-related illness (IRI). Results: Overall, 390,983 visits, and 88,885 visits for IRI, were included for Calendar Weeks 16 through 29, when 2009 H1N1 influenza was circulating. The subset of 106,330 visits and 31,703 IRI visits made to the 14 hospitals experiencing the authors' definition of ED surge during Weeks 16 to 29 was also studied. During surge weeks, the 14 EDs experienced 29% more total visits and 51% more IRI visits than expected (p < 0.01 for both comparisons). Of ED IRI visits during surge weeks, only 4.8% were admitted to non-intensive care beds (70% of expected, p < 0.01), 0.19% were admitted to intensive care units (44% of expected, p < 0.01), and 0.01% received mechanical ventilation (5.0% of expected, p < 0.01). Factors associated with more-than-expected visits included ages 2-17 years, payer type, and asthma. No factors were associated with more-than-expected hospitalizations from the ED. Conclusions: During the spring 2009 H1N1 influenza pandemic, pediatric EDs nationwide experienced a marked increase in visits, with far fewer than expected requiring nonintensive or intensive care hospitalization. The data in this study can be used for future pandemic planning. ACADEMIC EMERGENCY MEDICINE 2011; 18:158-166 (C) 2010 by the Society for Academic Emergency Medicine

引用

页码：158 / 166

页数：9

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