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{
    "pk": 16151,
    "title": "Caregiver Perceptions Regarding Alternative Emergency Medical Services Dispositions for Children: A Cross-Sectional Survey Analysis",
    "subtitle": null,
    "abstract": "Introduction:\n Emergency medical services (EMS) systems have developed alternative disposition processes for patients (including leaving the patient at the scene, using taxis, and transporting to clinics) vs taking patients directly to an emergency department (ED). Studies show that patients favorably support these alternative options but have not included the perspectives of caregivers of children. Our objective was to describe caregivers’ views about these alternative disposition processes and analyze whether caregiver support is associated with sociodemographic factors.\nMethods:\n We surveyed a convenience sample of caregivers in a pediatric ED. We asked caregivers 15 questions based on a previously validated survey. We then conducted logistic regressions to determine whether sociodemographic factors were associated with levels of support.\nResults:\n We enrolled 241 caregivers. The median age of their children was five years. The majority of respondents were non-Hispanic Black (57%) and had public insurance (65%). We found that a majority of respondents supported all alternative EMS disposition options. The overall level of agreement for survey questions ranged from 51-93%. We grouped questions by theme: non-transport; alternative destinations; communication with EMS physician; communication with primary care physician and sharing records; restricted EMS role; and shared decision-making. Regression analyses for each theme found that race/ethnicity, public insurance, and patient age were not significantly associated with the level of support.\nConclusion:\n Most caregivers were supportive of alternative EMS disposition options for children with low-acuity complaints. Support did not vary significantly by respondent race/ethnicity, public insurance status, or patient age.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "emergency medical services"
        },
        {
            "word": "patient acuity"
        },
        {
            "word": "triage"
        },
        {
            "word": "hotlines"
        },
        {
            "word": "surveys and questionnaires"
        }
    ],
    "section": "Pediatrics",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/896847jd",
    "frozenauthors": [
        {
            "first_name": "Caleb",
            "middle_name": "E",
            "last_name": "Ward",
            "name_suffix": "",
            "institution": "Division of Emergency Medicine, Children’s National Hospital, Washington, District of Columbia; The George Washington University School of Medicine & Health Sciences, Washington, District of Columbia",
            "department": "None"
        },
        {
            "first_name": "Jonathan",
            "middle_name": "",
            "last_name": "Gougelet",
            "name_suffix": "",
            "institution": "The George Washington University School of Medicine & Health Sciences, Washington, District of Columbia",
            "department": "None"
        },
        {
            "first_name": "Ryan",
            "middle_name": "",
            "last_name": "Pearman",
            "name_suffix": "",
            "institution": "Division of Emergency Medicine, Children’s National Hospital, Washington, District of Columbia",
            "department": "None"
        },
        {
            "first_name": "Gia",
            "middle_name": "M",
            "last_name": "Badolato",
            "name_suffix": "",
            "institution": "Division of Emergency Medicine, Children’s National Hospital, Washington, District of Columbia",
            "department": "None"
        },
        {
            "first_name": "Joelle",
            "middle_name": "N",
            "last_name": "Simpson",
            "name_suffix": "",
            "institution": "Division of Emergency Medicine, Children’s National Hospital, Washington, District of Columbia; The George Washington University School of Medicine & Health Sciences, Washington, District of Columbia",
            "department": "None"
        }
    ],
    "date_submitted": "2021-11-22T15:45:29Z",
    "date_accepted": "2021-11-22T15:45:29Z",
    "date_published": "2022-07-02T07:00:00Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/16151/galley/8100/download/"
        }
    ]
}