Original Article

CME Article: Relation Between Pediatric Emergency Department Activity and Patient Complexity

Authors: Barry Hahn MD, Jerel Chacko MD, Raquel Klinger , Yvonne Giunta MD


Objectives: Potentially projecting pediatric emergency department (ED) volume trends is a matter that has been researched extensively. It is vital to understand the relation between patient complexity and department volumes to properly staff and allocate resources within the ED. Multiple studies have analyzed ED volumes based on disease severity; however, the degree of illness was determined by triage classification. This study proposed a novel method of evaluating the relation between pediatric ED patient complexity, centered on Current Procedural Terminology (CPT) code, and day of the week.

Methods: This was a retrospective study of pediatric patients presenting to the ED between January 1, 2010 and December 31, 2015. This study looked at the relation between individuals with CPT codes who were evaluated in the pediatric ED on a particular day of the week and evaluated in the pediatric ED either the day before, the day of, and the day after a legal holiday.

Results: A total of 81,698 (54%) male and 70,002 (46%) female patients were analyzed. No relation was noted between ED patient complexity, based on their CPT code, and the day of the week (P = 0.41). Individual, nonstatistically significant differences between the day of the week and pediatric ED volumes were identified, however.

Conclusions: We identified no relation between pediatric ED patient complexity, assessed by CPT code, and the day of the week. Furthermore, a more multifactorial and granular analysis may be necessary to model resource constraints by type and time of day to more effectively manage ED resources. CPT-based modeling may benefit superimposed financial analyses of demand-capacity management.

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