التفاصيل البيبلوغرافية
| العنوان: |
Paediatric health care access in community health centres is associated with survival for critically ill children who undergo inter-facility transport: A province-wide observational study. |
| المؤلفون: |
Tijssen, Janice A1,2 Janice.tijssen@lhsc.on.ca, To, Teresa3,4, Morrison, Laurie J5,6, Alnaji, Fuad7,8, MacDonald, Russell D6,8, Cupido, Cynthia9, Lee, Kyong-Soon10,11, Parshuram, Christopher S2,4,11,12 |
| المصدر: |
Paediatrics & Child Health (1205-7088). Aug2020, Vol. 25 Issue 5, p308-316. 9p. |
| مصطلحات موضوعية: |
*COMMUNITY health services, *CONFIDENCE intervals, *CRITICALLY ill, *DEATH, *HEALTH care rationing, *HEALTH services accessibility, *LENGTH of stay in hospitals, *HOSPITAL admission & discharge, *INTENSIVE care units, *SCIENTIFIC observation, *HEALTH outcome assessment, *PATIENTS, *PEDIATRICS, *SURVIVAL, *RETROSPECTIVE studies, *TRANSPORTATION of patients, *DESCRIPTIVE statistics, *ODDS ratio |
| مصطلحات جغرافية: |
ONTARIO |
| مستخلص: |
Background Diverse settlement makes inter-facility transport of critically ill children a necessary part of regionalized health care. There are few studies of outcomes and health care services use of this growing population. Methods A retrospective study evaluated the frequency of transports, health care services use, and outcomes of all critically ill children who underwent inter-facility transport to a paediatric intensive care unit (PICU) in Ontario from 2004 to 2012. The primary outcome was PICU mortality. Secondary outcomes were 24-hour and 6-month mortality, PICU and hospital lengths of stay, and use of therapies in the PICU. Results The 4,074 inter-facility transports were for children aged median (IQR) 1.6 (0.1 to 8.3) years. The rate of transports increased from 15 to 23 per 100,000 children. There were 233 (5.7%) deaths in PICU and an additional 78 deaths (1.9%) by 6 months. Length of stay was median (IQR) 2 (1 to 5) days in PICU and 7 (3 to 14) days in the receiving hospital. Lower PICU mortality was independently associated with prior acute care contact (odds ratio [OR]=0.3, 95% confidence interval [CI]: 0.2 to 0.6) and availability of paediatric expertise at the referral hospital (OR=0.7, 95% CI: 0.5 to 1.0). Conclusions We found that in Ontario, children undergoing inter-facility transport to PICUs are increasing in number, consume significant acute care resources, and have a high PICU mortality. Access to paediatric expertise is a potentially modifiable factor that can impact mortality and warrants further evaluation. [ABSTRACT FROM AUTHOR] |
| قاعدة البيانات: |
Academic Search Index |
Full Text Finder