Children's National Health System Posters
Parental perceptions regarding alternative emergency medical services dispositions
Document Type
Poster
Status
Staff
Abstract Category
Health Policy and Management
Keywords
Emergency Medical Services (EMS), transport
Publication Date
Spring 2019
Abstract
Background: The proportion of patients arriving to emergency departments (ED) by Emergency Medical Services (EMS) has been steadily increasing. Many of these patients may not need emergency services at all, and could be seen more efficiently in a primary care or urgent care office. There is very little literature regarding parental preferences for alternative (non-ED) dispositions for pediatric patients after 911 has been called. In particular there is a paucity of data regarding the views of racial and ethnic minority parents, and those who rely on public insurance. There is no published literature regarding parental attitudes towards a 911-nurse triage line. Objective: To assess parental attitudes towards alternative EMS dispositions (including a nurse triage line), and to evaluate whether these attitudes vary by patient insurance status and race/ethnicity. Design/Methods: Single center cross-sectional study using a convenience sample of parents/guardians in an urban tertiary care pediatric ED waiting room. Participants completed a 15 item-questionnaire (5 point Likert scale questions) regarding attitudes towards data sharing, shared decision making, and alternative EMS destinations. Responses by insurance status and race/ethnicity were analyzed using chi square analyses. Results: Of 203 completed surveys, the majority of respondents were publicly insured (59%) and non-Hispanic (NH) black (74%)(Table 1). Most respondents (94%) want to be involved in decisions regarding EMS destination for their children and 89% support data sharing between EMS, hospitals, and primary care offices (Table 2). Smaller majorities support EMS being able to transport children to clinic settings (69%) or treat and leave children at home (54%). 61% of respondents agree with following the advice of a nurse triage line. Patients with public insurance show lower levels of support for some aspects of an alternative EMS disposition system (Table 3). We did not identify significant differences by racial group (Table 4). On completion of enrolment of additional Hispanic patients we plan to conduct a principal components analysis to identify clusters of questions with similar responses, and then conduct logistic regression analyses on selected questions to identify factors associated with acceptance of alternative EMS systems. Conclusion(s): A substantial majority of parents in our study were in favor of many aspects of alternative EMS disposition systems. Support for alternative EMS disposition systems may vary by insurance status.
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Open Access
1
Parental perceptions regarding alternative emergency medical services dispositions
Background: The proportion of patients arriving to emergency departments (ED) by Emergency Medical Services (EMS) has been steadily increasing. Many of these patients may not need emergency services at all, and could be seen more efficiently in a primary care or urgent care office. There is very little literature regarding parental preferences for alternative (non-ED) dispositions for pediatric patients after 911 has been called. In particular there is a paucity of data regarding the views of racial and ethnic minority parents, and those who rely on public insurance. There is no published literature regarding parental attitudes towards a 911-nurse triage line. Objective: To assess parental attitudes towards alternative EMS dispositions (including a nurse triage line), and to evaluate whether these attitudes vary by patient insurance status and race/ethnicity. Design/Methods: Single center cross-sectional study using a convenience sample of parents/guardians in an urban tertiary care pediatric ED waiting room. Participants completed a 15 item-questionnaire (5 point Likert scale questions) regarding attitudes towards data sharing, shared decision making, and alternative EMS destinations. Responses by insurance status and race/ethnicity were analyzed using chi square analyses. Results: Of 203 completed surveys, the majority of respondents were publicly insured (59%) and non-Hispanic (NH) black (74%)(Table 1). Most respondents (94%) want to be involved in decisions regarding EMS destination for their children and 89% support data sharing between EMS, hospitals, and primary care offices (Table 2). Smaller majorities support EMS being able to transport children to clinic settings (69%) or treat and leave children at home (54%). 61% of respondents agree with following the advice of a nurse triage line. Patients with public insurance show lower levels of support for some aspects of an alternative EMS disposition system (Table 3). We did not identify significant differences by racial group (Table 4). On completion of enrolment of additional Hispanic patients we plan to conduct a principal components analysis to identify clusters of questions with similar responses, and then conduct logistic regression analyses on selected questions to identify factors associated with acceptance of alternative EMS systems. Conclusion(s): A substantial majority of parents in our study were in favor of many aspects of alternative EMS disposition systems. Support for alternative EMS disposition systems may vary by insurance status.
Comments
Presented at Research Days 2019.