Emergency department utilization among pediatric spina bifida patients

Issue title: Immigration and Transition: Emerging Trends in Spina Bifida Care

Guest editors: Timothy Brei and Jonathan Porter Castillo

Article type: Research Article

Authors: Riddle, Stefanie^{a; e; *} | Meinzen-Derr, Jareen^{b; e} | Tabangin, Meredith^b | Woodward, Jason^{c; e} | Wiley, Susan^{d; e}

Affiliations: [a] Division of Neonatology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA | [b] Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA | [c] Division of Adolescent and Transition Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA | [d] Division of Developmental and Behavioral Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA | [e] Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, OH, USA

Correspondence: [*] Corresponding author: Stefanie Riddle, Division of Neonatology, Cincinnati Children’s Hospital, 3333 Burnet Ave MLC 7009, Cincinnati, OH 45229, USA. Tel.: +1 513 517 0089; E-mail: Stefanie.riddle@cchmc.org.

Abstract: PURPOSE: There is a gap in knowledge regarding the use of emergency services by pediatric spina bifida patients. The goal of this study was to describe Emergency Department utilization patterns in this population. METHODS: Through a retrospective observational study, patients with spina bifida who visited the emergency department during a four-year period were identified; medical and demographic information was obtained though the Centers for Disease Control National Spina Bifida Patient Registry. Chief complaints and final diagnoses of visits were classified and related to medical needs of spina bifida to determine the appropriate care level. RESULTS: Among 303 children within the registry, 161 patients (53%) accounted for 579 visits. 70% of visits were for spina bifida-related complaints. Approximately half (51.7%) had a shunt-related chief complaint, although final diagnosis was largely unrelated to the shunt. Admission rate was 39%, higher than institutional baseline, and largely represented by genitourinary (GU) complaints. CONCLUSION: Pediatric patients with spina bifida presenting to a single center emergency department were most likely to present with shunt and urinary concerns; these patients were most likely to be admitted. This potentially suggests that improving outpatient care for bladder management may decrease emergency department use among this population.

Keywords: Pediatrics, spina bifida, emergency care, resource utilization, special health care needs

DOI: 10.3233/PRM-180561

Journal: Journal of Pediatric Rehabilitation Medicine, vol. 12, no. 4, pp. 375-381, 2019