Clinical trial NCT01775033: Regionalized Pediatric Emergency Care in Rural Pennsylvania
Official title: Regionalized Pediatric Emergency Care in Rural Pennsylvania: the Optimizing Utilization and Rural Emergency Access for Children Study
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Emergencies
Keywords: Pediatrics
Emergency medical services
Emergency Treatment
Telemedicine
Lead sponsor: University of Pittsburgh
Sponsor class: OTHER
Collaborators: name: Health Resources and Services Administration (HRSA)
First posted: 2013-01-24
Enrollment: 5000
Sex: ALL
Maximum age (years): 18
Standard ages: CHILD
ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: SINGLE_GROUP
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: The overall goal of this project is to develop and evaluate an organized, regional system of pediatric emergency care in rural western Pennsylvania.

Detailed description: The OUTREACH project will develop, implement and evaluate an organized system of regional pediatric emergency care in rural western Pennsylvania. Toward that end the investigators have developed three broad goals: (1) to define the key barriers and potential solutions to regionalized pediatric emergency care through community stakeholder engagement; (2) to implement a regionalized system of pediatric emergency care using education, community outreach and telemedicine; and (3) evaluate the impact of the system on health care access and outcomes for rural children. The investigators will implement the intervention in a sample of rural hospitals in Pennsylvania using a staggered roll-out design, and compare outcomes of children seen in these hospitals to similar matched hospitals in the state, using Pennsylvania state Medicaid data to evaluate the impact of the intervention.

Eligibility criteria: Inclusion Criteria:

* Pennsylvania
* Medicaid beneficiary
* Less than or equal to 18 years of age

Exclusion Criteria:

* None

Primary outcomes:
measure: Average distance from home to the nearest facility with specialized pediatric emergency care capabilities
timeFrame: One-year
Secondary outcomes:
measure: Incidence of emergency transfers to CHP after an index community ED visit
timeFrame: 90 days
measure: Incidence of emergency transfers to CHP that do not result in a hospital admission
timeFrame: 90 days
measure: Total health care encounters outside the county within three months after an index community ED visit
timeFrame: 90 days
measure: Mortality after an index community ED visit for specified high-risk conditions (trauma, sepsis, and in the chronic disease population)
timeFrame: 90 days
Other outcomes:
Locations:
city: Pittsburgh
country: United States
facility: University of Pittburgh Medical Center
state: Pennsylvania
Study officials:
affiliation: University of Pittsburgh
name: Jeremy M Kahn, MD, MS
role: STUDY_DIRECTOR
References:
citation: Lorch SA, Myers S, Carr B. The regionalization of pediatric health care. Pediatrics. 2010 Dec;126(6):1182-90. doi: 10.1542/peds.2010-1119. Epub 2010 Nov 1.
citation: Berger E. Growing pains: Report notes pediatric emergencies need greater emphasis. Ann Emerg Med. 2006 Aug;48(2):143-4. doi: 10.1016/j.annemergmed.2006.06.024. No abstract available.