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Increasing ambulatory treatment of pediatric minor burns-The emerging paradigm for burn care in children.
- Source :
-
Burns (03054179) . Feb2019, Vol. 45 Issue 1, p165-172. 8p. - Publication Year :
- 2019
-
Abstract
- <bold>Introduction: </bold>Innovations in topical burn treatment along with a drive toward value-based care are steering burn care to the outpatient setting. Little is known regarding what characteristics predict outpatient treatment of pediatric minor burns and whether there is a temporal trend toward this treatment paradigm.<bold>Methods: </bold>A retrospective cohort study was performed using California's Office of Statewide Health Planning and Development linked emergency department and inpatient database (2005-2013). All patients under 18years of age with a primary burn diagnosis were extracted. Using patient and facility level variables, we used regression modeling to evaluate predictors of outpatient burn treatment and temporal trends.<bold>Results: </bold>There were 16,480 pediatric minor burn encounters during the period. 56.4% were male, 85.3% had <10% total body surface area (TBSA), 76.3% were scald or contact, and 77.3% were at deepest depth 2nd degree. Multiple variables predicted an increased likelihood of discharge home including older age(p<0.001), smaller TBSA(p<0.001), and superficial/partial thickness burns(< 0.001). Children of Hispanic and Black race were less likely to be discharged home compared to White and Asian peers(p=<0.001). On Poisson modeling, the incidence rate ratio over the 9-year period for home discharge was 1.004 (95% CI 1.001-1.008, p=0.032).<bold>Conclusion: </bold>Older patients and those with more superficial burns were more likely to be treated as outpatients. Black and non-white Hispanic race was associated with inpatient admission. There is a growing trend toward ambulatory treatment of minor burns in the pediatric population. Further research is needed to assess whether outpatient treatment of pediatric minor burns results in greater readmissions. [ABSTRACT FROM AUTHOR]
- Subjects :
- *BODY surface area
*PEDIATRIC therapy
*OUTPATIENT medical care
*HEALTH planning
*REGRESSION analysis
*TREATMENT for burns & scalds
*STATISTICS on Hispanic Americans
*AGE distribution
*BLACK people
*ETHNIC groups
*HOSPITAL emergency services
*LONGITUDINAL method
*POISSON distribution
*POPULATION geography
*WHITE people
*DISCHARGE planning
*RETROSPECTIVE studies
*TRAUMA severity indices
Subjects
Details
- Language :
- English
- ISSN :
- 03054179
- Volume :
- 45
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- Burns (03054179)
- Publication Type :
- Academic Journal
- Accession number :
- 133972606
- Full Text :
- https://doi.org/10.1016/j.burns.2018.08.031