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Dedicated Pediatricians in Emergency Department: Shorter Waiting Times and Lower Costs

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  • Manuel Rocha Melo
  • Manuel Ferreira-Magalhães
  • Filipa Flor-Lima
  • Mariana Rodrigues
  • Milton Severo
  • Luis Almeida-Santos
  • Alberto Caldas-Afonso
  • Pedro Pita Barros
  • António Ferreira

Abstract

Background: 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.

Suggested Citation

  • Manuel Rocha Melo & Manuel Ferreira-Magalhães & Filipa Flor-Lima & Mariana Rodrigues & Milton Severo & Luis Almeida-Santos & Alberto Caldas-Afonso & Pedro Pita Barros & António Ferreira, 2016. "Dedicated Pediatricians in Emergency Department: Shorter Waiting Times and Lower Costs," PLOS ONE, Public Library of Science, vol. 11(8), pages 1-12, August.
    • Handle: RePEc:plo:pone00:0161149
    DOI: 10.1371/journal.pone.0161149
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    References listed on IDEAS

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    1. Koenker, Roger W & Bassett, Gilbert, Jr, 1978. "Regression Quantiles," Econometrica, Econometric Society, vol. 46(1), pages 33-50, January.
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