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Dedicated pediatricians in emergency department

2016-08-01Artigo científico Acesso aberto
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dc.contributor.authorMelo, Manuel Rocha
dc.contributor.authorFerreira-Magalhães, Manuel
dc.contributor.authorFlor-Lima, Filipa
dc.contributor.authorRodrigues, Mariana
dc.contributor.authorSevero, Milton
dc.contributor.authorAlmeida-Santos, Luis
dc.contributor.authorCaldas-Afonso, Alberto
dc.contributor.authorBarros, Pedro Pita
dc.contributor.authorFerreira, António
dc.contributor.institutionNOVA School of Business and Economics (NOVA SBE)
dc.contributor.pblPLOS - Public Library of Science
dc.date.accessioned2024-03-15T22:10:44Z
dc.date.available2024-03-15T22:10:44Z
dc.date.issued2016-08-01
dc.description.abstractBackground: Dedicated pediatricians in emergency departments (EDs) may be beneficial, though no previous studies have assessed the related costs and benefits/harms. We aimed to evaluate the net benefits and costs of dedicated emergency pediatricians in a pediatric ED. Methods: Cost-consequences analysis of visits to a pediatric ED of a tertiary hospital. Two pediatric ED Medical Teams (MT) were compared: MT-A (May-September 2012), with general pediatrics physicians only; and MT-B (May-September 2013), with emergency dedicated pediatricians. The main outcomes analyzed were relevant clinical outcomes, patient throughput time and costs. Results: We included 8,694 children in MT-A and 9,417 in MT-B. Medication use in the ED increased from 42.3% of the children in MT-A to 49.6% in MT-B; diagnostic tests decreased from 24.2% in MT-A to 14.3% in MT-B. Hospitalization increased from 1.3% in MT-A to 3.0% in MT-B; however, there was no significant difference in diagnosis-related group relative weight of hospitalized children in MT-A and MT-B (MT-A, 0.979; MT-B, 1.075). No differences were observed in ED readmissions or in patients leaving without being seen by a physician. The patient throughput time was significantly shorter in MT-B, with faster times to first medical observation. Within the cost domains analyzed, the total expenditures per children observed in the ED were 16% lower in MT-B: 37.87 euros in MT-A; 31.97 euros in MT-B. Conclusion: The presence of dedicated emergency pediatricians in a pediatric ED was associated with significantly lower waiting times in the ED, reduced costs, and similar clinical outcomes.en
dc.description.versionpublished
dc.format.extent794421
dc.identifier.doi10.1371/journal.pone.0161149
dc.identifier.issn1932-6203
dc.identifier.otherPURE: 1922915
dc.identifier.otherPURE UUID: 3ade9d7c-198e-4ce2-8484-bf0579c92e69
dc.identifier.otherScopus: 84990216394
dc.identifier.otherWOS: 000382496300007
dc.identifier.otherORCID: /0000-0002-0881-4928/work/56430464
dc.identifier.urihttp://hdl.handle.net/10362/164995
dc.identifier.urlhttps://www.scopus.com/pages/publications/84990216394
dc.language.isoeng
dc.peerreviewedyes
dc.subjectGeneral Medicine
dc.subjectGeneral Biochemistry,Genetics and Molecular Biology
dc.subjectGeneral Agricultural and Biological Sciences
dc.titleDedicated pediatricians in emergency departmenten
dc.title.subtitleShorter waiting times and lower costsen
dc.typejournal article
degois.publication.issue8
degois.publication.titlePLoS ONE
degois.publication.volume11
dspace.entity.typePublication
rcaap.rightsopenAccess

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