Comparative Effectiveness of Direct Admission & Admission Through Emergency Departments for Children

Summary

At a national level, emergency departments (EDs) serve as the portal of hospital admission for 75% of hospitalized children. The remainder occur via direct admission, defined as admission to hospital without first receiving care in the hospital's ED. The overall goals of this research are to: (i) implement pediatric direct admission systems at 3 hospitals, (ii) compare the timeliness of healthcare delivery for children who are admitted directly and through emergency departments, (iii) determine which patient populations achieve the greatest benefits from direct admission, and (iv) identify barriers and facilitators of successful implementation.

Conditions

• Hospitalization
• Child Health

Interventions

BEHAVIORAL

Direct admission

Process of pediatric admission is through admission directly into the pediatric hospital medicine unit

BEHAVIORAL

ED admission

Process of pediatric admission is through the emergency department

Sponsors & Collaborators

• Patient-Centered Outcomes Research Institute

  collaborator OTHER

• Nationwide Children's Hospital

  collaborator OTHER

• Providence Health & Services

  collaborator OTHER

• University of Pittsburgh

  collaborator OTHER

• Dartmouth College

  collaborator OTHER

• Seattle Children's Hospital

  collaborator OTHER

• Dartmouth-Hitchcock Medical Center

  lead OTHER

Principal Investigators

• JoAnna K Leyenaar, MD, PhD · Dartmouth-Hitchcock Medical Center; Geisel School of Medicine at Dartmouth

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Model

CROSSOVER

Eligibility

Min Age

30 Days

Max Age

17 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2020-02-01

Primary Completion

2023-04-30

Completion

2023-07-31

Countries

• United States

Study Locations