N/A
N=134
Comparative Effectiveness of Direct Admission & Admission Through Emergency Departments for Children
Hospitalization · Child Health
Bottom Line
View on ClinicalTrials.gov: NCT04192799 ↗Enrolled (actual)
134
Serious AEs
0.0%
Results posted
Oct 2024
Primary outcome: Primary: Timeliness of Clinical Care - Initial Therapeutic Management — 142; 153 minutes — p=<0.001
Study Design & Population
- Study type
- Interventional
- Phase
- N/A
- Interventions
- Direct admission (Behavioral); ED admission (Behavioral)
- Age
- Pediatric · 0+ yrs
- Sex
- All
- Sponsor
- Dartmouth-Hitchcock Medical Center
- Primary completion
- Apr 2023
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Timeliness of Clinical Care - Initial Therapeutic Management |
142; 153 | <0.001 sig |
| PRIMARY Timeliness of Clinical Care - Initial Clinical Assessment |
25; 13 | <0.001 sig |
| PRIMARY Timeliness of Clinical Care - Initial Diagnostic Testing |
120.5; 99 | 0.37 |
| SECONDARY Number of Participants With Clinical Deterioration |
1; 15 | 0.81 |
| SECONDARY Pediatric Hospitalization Admission Survey of Experience (PHASE) |
0.75; 0.71 | 0.12 |
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.
Eligibility Criteria
Inclusion Criteria
Child has one of the following presenting diagnoses:
- gastroenteritis
- dehydration
- skin and soft tissue infection
- urinary tract infection/pyelonephritis
- pneumonia
- viral infection not otherwise specified
- influenza
Exclusion Criteria
Ineligible children include those:
- with planned admissions (i.e., chemotherapy)
- admitted to non-pediatric hospital medicine services (i.e., intensive care)
- transferred from other hospitals
Data sourced from ClinicalTrials.gov (NCT04192799). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.