Regionalized Pediatric Emergency Care in Rural Pennsylvania

Not Applicable

Completed

• Conditions: Emergencies
• Interventions: Other: Multicomponent intervention

• Registration Number: NCT01775033
• Lead Sponsor: University of Pittsburgh

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 Timeline

• Study Start: 2012-06
• Study First Submitted: 2013-01-21
• Study First Submitted QC: 2013-01-23
• Study First Posted: 2013-01-24
• Primary Completion: 2016-06
• Study Completion: 2016-06
• Status Verified: 2016-10
• Last Update Submitted: 2016-10-25
• Last Update Posted: 2016-10-27

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 5000

Inclusion Criteria

• Pennsylvania
• Medicaid beneficiary
• Less than or equal to 18 years of age

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Exclusion Criteria

• None

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Multicomponent intervention	Multicomponent intervention	Hospitals in the experimental arm will receive a four-component intervention that integrates local education, community outreach, telemedicine and protocolized triage and transport

Primary Outcome Measures

Name	Time	Method
Average distance from home to the nearest facility with specialized pediatric emergency care capabilities	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 Outcome Measures

Name	Time	Method
Mortality after an index community ED visit for specified high-risk conditions (trauma, sepsis, and in the chronic disease population)	90 days	These outcomes will address our goal to increase child health and related to the HRSA Maternal Child Health Bureau performance measures MICH-1,2 and 3
Total health care encounters outside the county within three months after an index community ED visit	90 days
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

Trial Locations

Locations (1)

University of Pittburgh Medical Center; 🇺🇸 Pittsburgh, Pennsylvania, United States