In 2006, the Institute of Medicine published its report "Emergency Care for Children: Growing Pains" as part of its Future of Emergency Care series. Children comprise 27% of all emergency room admissions; yet, one survey found that only 6% of emergency departments have all the supplies needed to handle pediatric emergencies. While many large cities have dedicated children's hospitals or facilities with pediatric emergency departments, many general hospitals do not have either the equipment necessary to provide optimal pediatric emergency care nor staff that is specifically trained in the care of pediatric emergencies. The ability of emergency departments to meet the needs of all patients, including children and adolescents, is an essential component of our nation's ability to meet the health care needs of all citizens. This project provides an opportunity to determine the equipment and training needs of rural emergency departments, highlighting those areas that may be amenable to straightforward interventions, such as grants to purchase pediatric equipment, or more accessible education in pediatric advanced life support (PALS).

This project involves two components. First, we will use the 2002-2003 Emergency Pediatric Services and Equipment Supplement (EPSES) from the National Hospital Ambulatory Medical Care Survey (NHAMCS) to examine the availability of pediatric services, expertise, and supplies between urban and rural emergency departments in the U.S. To obtain a more in-depth understanding of the factors that influence the availability of pediatric services, expertise, and supplies in rural emergency departments, we will also conduct semi-structured, in-depth interviews with hospital staff in a sample of approximately 75 rural hospitals. Data from the EPSES surveys and the interviews will be analyzed using descriptive, bivariate, and regression analyses in order to address how the availability of pediatric services, expertise and supplies in U.S. emergency departments differ between urban and rural facilities, and to determine which factors impede the availability of pediatric services, expertise, and supplies in rural emergency departments. Study results will be presented in a final report and findings brief.

Publications

• Pediatric Care in Rural Hospital Emergency Departments (Final Report)
  North Carolina Rural Health Research and Policy Analysis Center
  Date: 05/2010
  This report analyzes data from the Emergency Pediatric Services and Equipment Supplement to the National Hospital Ambulatory Medicare Care Survey to compare rural and urban hospitals' responses on various dimensions of pediatric emergency department care.
• Pediatric Care in Rural Hospital Emergency Departments (Findings Brief)
  North Carolina Rural Health Research and Policy Analysis Center
  Date: 05/2010
  This brief analyzes data from the Emergency Pediatric Services and Equipment Supplement to the National Hospital Ambulatory Medical Care Survey. Rural/urban hospitals' responses on pediatric emergency department (ED) care were compared. Rural ED directors also were surveyed to further explore rural pediatric ED care in more detail.