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Emergency Department Resource Use in Pediatric Pneumonia: Point‐of‐Care Lung Ultrasonography versus Chest Radiography
Author(s) -
HarelSterling Maya,
Diallo Mamadou,
Santhirakumaran Sabeena,
Maxim Timea,
Tessaro Mark
Publication year - 2019
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.1002/jum.14703
Subject(s) - medicine , emergency department , radiography , pneumonia , point of care , emergency medicine , retrospective cohort study , radiology , lung , cohort , pediatrics , surgery , nursing
Objectives Point‐of‐care lung ultrasonography (US) is an alternative to chest radiography for imaging of suspected community‐acquired pneumonia (CAP) in children. We compared pediatric emergency department (ED) time metrics between children who received point‐of‐care lung US versus chest radiography. Secondary objectives were comparisons of health system costs and other resources in these imaging groups. Methods This work was a retrospective matched cohort study of children aged 0 to 18 years in an academic urban pediatric ED who were imaged for suspected CAP with either point‐of‐care lung US or chest radiography. Results A total of 202 patients (101 in each group) were included in the study. The point‐of‐care lung US group spent a mean of 75.9 (SE, 14.3) minutes less from physician assessment to discharge ( P < .0001) and 60.9 (SE, 18.1) minutes less in the overall ED length of stay ( P = .0008). Physician billings and facility fees were both significantly lower ( P < .0001) in the point‐of‐care lung US group, for a mean health systems savings of CAN$187.1 (SE, CAN$21.9). Conclusions In children undergoing imaging for suspected CAP in our pediatric ED, point‐of‐care lung US by pediatric emergency medicine physicians was associated with decreased time and cost compared with chest radiography.