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ED Pediatric Readiness Cuts In-Hospital Mortality

However, pediatric readiness does not eliminate Black mortality disparity for children’s medical emergencies

By Lori Solomon HealthDay Reporter

TUESDAY, Sept. 12, 2023 (HealthDay News) — Increased readiness of emergency departments to handle pediatric patients is associated with lower in-hospital mortality, according to a study published online Sept. 5 in JAMA Network Open.

Peter C. Jenkins, M.D., from Indiana University School of Medicine in Indianapolis, and colleagues evaluated the association of an emergency department’s pediatric readiness with in-hospital mortality among children of different races and ethnicities with traumatic injuries or acute medical emergencies. The analysis included data from 633,536 children (younger than 18 years) requiring emergency care in 586 emergency departments across 11 states (2012 through 2017).

The researchers found that adjusted mortality of Black children with acute medical emergencies was significantly greater than that of Hispanic children, White children, and children of other races and ethnicities (odds ratio [OR], 1.69; 95 percent confidence interval [CI], 1.59 to 1.79), with findings consistent across all quartile levels of emergency department pediatric readiness. When comparing Black children with traumatic injuries with Hispanic children, White children, and children of other races and ethnicities with traumatic injuries, there were no racial or ethnic disparities in mortality (OR, 1.01; 95 percent CI, 0.89 to 1.15). Children who were treated at hospitals in the highest quartile had significantly lower mortality for both acute medical emergencies (OR, 0.24; 95 percent CI, 0.16 to 0.36) and traumatic injuries (OR, 0.39; 95 percent CI, 0.25 to 0.61) compared with hospitals in the lowest quartile of emergency department pediatric readiness.

“These findings suggest that increased emergency department pediatric readiness may reduce but not eliminate disparities among children with acute medical emergencies, indicating that organizations and initiatives dedicated to increasing emergency department pediatric readiness should consider formal integration of health equity into efforts to improve pediatric emergency care,” the authors write.

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