Many Adults With Pediatric Disorders Use Pediatric ERs

Transition patients have high rates of intensive care unit, hospital admission
By Monica Smith
HealthDay Reporter

TUESDAY, June 8 (HealthDay News) -- Many adult patients with chronic pediatric disorders, known as transition patients, use pediatric emergency departments -- often for complaints unrelated to their pediatric disorders -- and these patients have high rates of intensive care unit and hospital admissions, according to a study in the June issue of the Archives of Pediatrics & Adolescent Medicine.

William M. McDonnell, M.D., of the University of Utah in Salt Lake City, and colleagues evaluated all patients that presented to the pediatric emergency department of a tertiary care pediatric hospital in 2005 to explain the use of pediatric emergency departments by transition patients.

The researchers found that of the 43,621 patient encounters, 445 (1 percent) involved adult patients. Of those 445 encounters, 197 (44 percent) were transition patients, 89 of whom sought help for conditions unrelated to their chronic pediatric condition. The majority of transition patient visits (93 percent) entailed diagnostic studies or procedures. Transition patients were twice as likely to require admission and 4.5 times more likely to need intensive care than pediatric patients. Their median length of stay was twice as long -- four days versus two days -- than the median duration for pediatric patients.

"These patients require a large quantity of diagnostic and treatment resources relative to their numbers. As this cohort of transition patients continues to grow, pediatric emergency departments should carefully consider how best to provide transition patients with appropriate care. Unless large-scale policy decisions are made to provide acute care for these patients at adult facilities, pediatric hospitals should be prepared with adequate resources and training to deal with these complex adult patients," the authors conclude.

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