Multicenter retrospective review of adult patients presenting to pediatric emergency departments impact of interfacility distance

Objective: This descriptive study aimed at evaluating the impact of distance between a general and pediatric emergency department (PED) on adults seeking care at PEDs. Methods: The Pediatric Health Information Systems database was used to perform a retrospective study of all adult patients presenting to PEDs from 2005 to 2015. Data regarding age, disposition, pregnancy status, insurance status, median household income, all-patients refined diagnosis-related groups, and procedures were gathered. Distances were categorized as PEDs less than 1 mile and 1 mile from a general facility. Data were analyzed for the entire population, in addition to those 45 years old. Results: The majority of patients were discharged from the ED; transfers were more frequent at PEDs 1 mile away from a general facility. Death was rare, with minimal differences noted between interfacility distances (21: 0.25% vs 0.24%; 45: 0.36% vs 0.32%). Cardiopulmonary resuscitation occurred in 0.25% with no differences based on location. Pregnant women visits and childbirth occur more frequently in PEDs closer to general facilities (4.89% vs 2.85%, P < 0.05; 0.07% vs 0.03%, P < 0.05, respectively). Chest pain was seen more frequently at PEDs located farther away from general EDs, the difference more pronounced in those 45 years old (21: 5.12% vs 6.3%; 45: 6.61% vs 13.17%). Conclusions: Statistically significant differences were seen in the adult population presenting to PEDs based on the interfacility distance between a pediatric and general ED. These data can help PEDs prepare for the adult patients they are more likely to treat.