OBJECTIVE To determine if race/ethnicity-based differences exist in the management of pediatric abdominal pain in emergency departments (EDs). METHODS Secondary analysis of data from the 2006-2009 National Hospital Ambulatory Medical Care Survey regarding 2298 visits by patients ≤ 21 years old who presented to EDs with abdominal pain. Main outcomes were documentation of pain score and receipt...

BACKGROUND Patients with low-risk chest pain are frequently readmitted for evaluation of recurrent chest pain. It is unknown whether stress testing during the first admission for chest pain is a cost-effective means of reducing readmissions. METHODS Using a hospital administrative database, we conducted a retrospective cohort study of patients aged ≥18 years admitted under "observation status...

BACKGROUND Clinicians cannot provide all recommended preventive services in a single office visit and must learn to prioritize. This skill is not overtly addressed in medical school. METHODS We designed a workshop to teach third-year medical students to prioritize preventive services during an office visit. In a prospective controlled trial, we compared performance on a standardized patient c...

The objective of this study was to examine mental health follow-up patterns and need for additional urgent ED evaluation in adolescents discharged home from a pediatric ED after an evaluation for suicidal ideation or attempt. In the study, the parent or guardian of suicidal youth ages 11 to 18 years who were discharged from the pediatric ED were interviewed by telephone between 1 and 2 months f...

BACKGROUND Hospital in the Home (HIH) research is characterised by small samples in new programs. We sought to examine a large number of consecutive HIH admissions over many years in an established, medically-managed HIH service in to determine whether: (1) HIH is a safe and effective method of delivering acute hospital care, under usual operating conditions in an established unit; and (2) what...

OBJECTIVE To determine the effectiveness of pre-discharge home assessment visits by occupational therapists in assisting hospitalized patients from a range of settings to return to community living. DATA SOURCES Electronic databases MEDLINE, CINAHL, Embase, PsychINFO, Cochrane Central Register of Controlled Trials and OTseeker were searched until February 2014. STUDY SELECTION Quantitative ...

OBJECTIVE To determine the clinical effectiveness and cost-effectiveness of 3 inhaled corticosteroid (ICS) delivery options for children with asthma treated in and discharged from the emergency department (ED). STUDY DESIGN We conducted cost-effectiveness analysis using a decision tree to compare 3 ED-based ICS delivery options: usual care (recommending outpatient follow-up), prescribe (unifo...

The American Academy of Pediatrics policy statement "Options Counseling for the Pregnant Adolescent Patient" recommends the basic content of the pediatrician's counseling for an adolescent facing a new diagnosis of pregnancy. However, options counseling is just one aspect of what may be one of the more challenging scenarios in the pediatric office. Pediatricians must remain alert to the possibi...