Regionalized Pediatric Emergency Care in Rural Pennsylvania: the Optimizing Utilization and Rural Emergency Access for Children Study
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- University of Pittsburgh
- Enrollment
- 5,000
- Locations
- 2
- Primary Endpoint
- Average distance from home to the nearest facility with specialized pediatric emergency care capabilities
Study Overview
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.
Study Design
- Study Type
- Interventional
- Allocation
- Non Randomized
- Intervention Model
- Single Group
- Primary Purpose
- Health Services Research
- Masking
- None
Eligibility Criteria
- Ages
- — to 18 Years (Child, Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Pennsylvania
- •Medicaid beneficiary
- •Less than or equal to 18 years of age
Exclusion Criteria
- Not provided
Outcomes
Primary Outcomes
Average distance from home to the nearest facility with specialized pediatric emergency care capabilities
Time Frame: One-year
This population-based outcome will act as a measure of access and relates to HRSA Maternal Child Health Bureau performance measure AHS-8 and AHS-9 (access to pre-hospital EMS and wait times)
Secondary Outcomes
- Incidence of emergency transfers to CHP after an index community ED visit(90 days)
- Incidence of emergency transfers to CHP that do not result in a hospital admission(90 days)
- Mortality after an index community ED visit for specified high-risk conditions (trauma, sepsis, and in the chronic disease population)(90 days)
- Total health care encounters outside the county within three months after an index community ED visit(90 days)
Investigators
Jeremy Kahn
Associate Professor of Critical Care, Medicine and Health Policy & Management
University of Pittsburgh