Characteristics of Emergency Room and Hospital Encounters Resulting From Consumer Home Monitors.


Journal

Hospital pediatrics
ISSN: 2154-1671
Titre abrégé: Hosp Pediatr
Pays: United States
ID NLM: 101585349

Informations de publication

Date de publication:
01 07 2022
Historique:
pubmed: 29 6 2022
medline: 6 7 2022
entrez: 28 6 2022
Statut: ppublish

Résumé

Consumer home monitors (CHM), which measure vital signs, are popular products marketed to detect airway obstruction and arrhythmia. Yet, they lack evidence of infant death prevention, demonstrate suboptimal accuracy, and may result in false alarms that prompt unnecessary acute care visits. To better understand the hospital utilization and costs of CHM, we characterized emergency department (ED) and hospital encounters associated with CHM use at a children's hospital. We used structured query language to search the free text of all ED and admission notes between January 2013 and December 2019 to identify clinical documentation discussing CHM use. Two physicians independently reviewed the presence of CHM use and categorized encounter characteristics. Evidence of CHM use contributed to the presentation of 36 encounters in a sample of over 300 000 encounters, with nearly half occurring in 2019. The leading discharge diagnoses were viral infection (13, 36%), gastroesophageal reflux (8, 22%) and false positive alarm (6, 17%). Median encounter duration was 20 hours (interquartile range: 3 hours to 2 days; max 10.5 days) and median cost of encounters was $2188 (interquartile range: $255 to $7632; max $84 928). Although the annual rate of CHM-related encounters was low and did not indicate a major public health burden, for individual families who present to the ED or hospital for concerns related to CHMs, there may be important adverse financial and emotional consequences.

Sections du résumé

BACKGROUND AND OBJECTIVES
Consumer home monitors (CHM), which measure vital signs, are popular products marketed to detect airway obstruction and arrhythmia. Yet, they lack evidence of infant death prevention, demonstrate suboptimal accuracy, and may result in false alarms that prompt unnecessary acute care visits. To better understand the hospital utilization and costs of CHM, we characterized emergency department (ED) and hospital encounters associated with CHM use at a children's hospital.
METHODS
We used structured query language to search the free text of all ED and admission notes between January 2013 and December 2019 to identify clinical documentation discussing CHM use. Two physicians independently reviewed the presence of CHM use and categorized encounter characteristics.
RESULTS
Evidence of CHM use contributed to the presentation of 36 encounters in a sample of over 300 000 encounters, with nearly half occurring in 2019. The leading discharge diagnoses were viral infection (13, 36%), gastroesophageal reflux (8, 22%) and false positive alarm (6, 17%). Median encounter duration was 20 hours (interquartile range: 3 hours to 2 days; max 10.5 days) and median cost of encounters was $2188 (interquartile range: $255 to $7632; max $84 928).
CONCLUSIONS
Although the annual rate of CHM-related encounters was low and did not indicate a major public health burden, for individual families who present to the ED or hospital for concerns related to CHMs, there may be important adverse financial and emotional consequences.

Identifiants

pubmed: 35762227
pii: 188352
doi: 10.1542/hpeds.2021-006438
pmc: PMC9355114
mid: NIHMS1822277
doi:

Types de publication

Journal Article Research Support, U.S. Gov't, P.H.S.

Langues

eng

Sous-ensembles de citation

IM

Pagination

e239-e244

Subventions

Organisme : AHRQ HHS
ID : R18 HS026620
Pays : United States

Informations de copyright

Copyright © 2022 by the American Academy of Pediatrics.

Références

Glob Pediatr Health. 2017 Dec 04;4:2333794X17742751
pubmed: 29230431
JAMA. 2013 Jun 19;309(23):2445-6
pubmed: 23645117
Pediatrics. 2003 Apr;111(4 Pt 1):914-7
pubmed: 12671135
J Pediatr. 2021 May;232:147-153.e1
pubmed: 33421423
JAMA. 2018 Aug 21;320(7):717-719
pubmed: 30140866
Pediatrics. 2016 Nov;138(5):
pubmed: 27940805

Auteurs

Sansanee Craig (S)

Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Pennsylvania.
Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.

Irit R Rasooly (IR)

Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Pennsylvania.
Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Section of Hospital Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

Andrew S Kern-Goldberger (AS)

Section of Hospital Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

Brooke Luo (B)

Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Pennsylvania.
Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Section of Hospital Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

Mark V Mai (MV)

Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Pennsylvania.
Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

Jonathan M Beus (JM)

Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Pennsylvania.
Section of Hospital Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Division of Hospital Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia.
Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.

J Grey Faulkenberry (JG)

Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Pennsylvania.
Section of Hospital Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

Canita Brent (C)

Section of Hospital Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

Daniel Herchline (D)

Section of Hospital Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio.

Naveen Muthu (N)

Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Pennsylvania.
Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Section of Hospital Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

Christopher P Bonafide (CP)

Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Pennsylvania.
Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Section of Hospital Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

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