Direct admission to hospitals among children in the United States.

Direct Admission toHospitals Among Children in theUnited States While a decade of research and policy interventions has begun to transform hospital discharge processes, research focused on hospital admissions is lacking. Emergency departments (EDs) are increasingly serving as portals of hospital admission, contributing to national concerns about ED volumes,wait times, anddiscontinuityof care.1Despite this, there is a paucity of research examining other options for hospital admission. Direct admission, defined as admission to a hospitalwithout receiving care in the hospital’s ED, is 1 alternative. Althoughdirect admissionhaspotential benefits forpatients and health care systems, little is known about its use or effectiveness. To our knowledge, only 1 study has examined outcomes associated with pediatric direct admissions and there are no national statistics about the characteristics of this admission approach.2 To address this gap, we used a nationally representative data set to determine pediatric direct admission rates, characteristics, and costs relative to admission through EDs and characterize variation in direct admission rates across diagnoses and hospitals.