A research article published on November 1, 2024 on JAMA Network entitled “State and National Estimates of the Cost of Emergency Department Pediatric Readiness and Lives Saved” found: “Our results suggest that more than one quarter of deaths among children receiving emergency care in the US may be preventable through ED pediatric readiness … Among children presenting to EDs who died within 1 year, death most commonly occurred at the initial ED and often within hours of arrival.”
“Based on the way that ED pediatric readiness is organized and conceptualized, any hospital can achieve high ED pediatric readiness, regardless of inpatient services or hospital type. The opportunity for all EDs to reach high pediatric readiness allows small EDs in rural regions to provide the same level of high-quality emergency care to children as large tertiary care hospitals in urban settings … The state-specific costs per child resident to raise all EDs to high readiness were modest, ranging from $0 to $12 per year.”
“We estimated that 669 019 at-risk children receive emergency services in 4840 EDs across the US each year. Among the 4840 EDs, the median (IQR) wPRS was 69 (59-82; range, 26-100). Based on current levels of ED pediatric readiness, 842 of 4840 EDs (17.4%) had high readiness (ie, wPRS 88 or above) with a range of 2.9% in Arkansas to 100% in Delaware. The annual cost for all EDs in the US to reach high ED pediatric readiness from current levels was $207 335 302 (95% CI, $188 401 692-$226 268 912), ranging from $0 in Delaware to $18 045 405 in Texas … The annual costs per child to reach universal high ED pediatric readiness ranged from $0 in Delaware to $11.84 in North Dakota.”
“Among the 669 019 at-risk children cared for in EDs each year, we estimated that 7619 (1.1%) die during the acute care visit, including ED and inpatient deaths. The annual number of pediatric deaths under current levels of ED readiness ranged from 8 in Wyoming to 691 in Texas. We estimated that 2143 (28.1%; 95% CI, 678-3608) of the 7619 childhood deaths each year may be preventable through universal high ED pediatric readiness, ranging from zero in Delaware (100% of EDs currently at high readiness) to 507 in New York (25.8% of EDs currently at high readiness). … Population-adjusted estimates for the number of additional pediatric lives that may be saved varied from zero in Delaware to 69 in South Dakota.”
Included in the patients studied were children aged 0 to 17 years receiving emergency services and requiring hospitalization, transferred for hospitalization to a different hospital, or who died in the ED (collectively termed at-risk children). Children were followed through the duration of their hospital stay. At-risk children are sensitive to different levels of ED pediatric readiness and represent approximately 3.7% of all children presenting to EDs
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