Montana — SPROC

Description

This Toolkit provides resources and training to facilitate the development of cultural competence and humility in one’s self, colleagues, the work environment and its application to practice

Description

This webinar focused on the importance of cultural sensitivity in the provision of care to American Indian children and families, the cultural difference in providing care to Native American reservation and urban children and families, as well as barriers to implementing culturally sensitive strategies.

Author(s)/Presenter(s)

Jason Mahoney

Abstract/Description

Update on the MT SPROC Program.
https://bit.ly/3lHecvF

Author(s)/Presenter(s)

Timothy Horeczko, James Marvin, Jeremy Kahn, Robert Sapien

Abstract/Description

Context: National groups call for the regionalization of health care, to direct patients with high-risk conditions to designated hospitals with greater capabilities. Currently there is limited information detailing the characteristics and specific needs of acutely ill and injured children who require transfer to another institution, especially in underserved rural communities.

Purpose: To determine the epidemiology of pediatric transfers from urban and rural emergency departments (EDs).

Methods: We analyzed data in the National Hospital Ambulatory Medical Care Survey from 1995 to 2010. Eligible children were <18 years of age seen in a United States ED, and transferred to another hospital after initial evaluation.

Findings: Of all 283,232,058 pediatric ED visits, less than 0.5% resulted in a transfer, yielding a population-based estimate of 900,100 transfers nationally during this period. Urban and rural EDs showed similar transfer rates. Children transferred from rural EDs were older and more likely to arrive by emergency medical services than children transferred from urban EDs (12.1 vs 8.2 years of age, P < .01). Children from rural EDs were more than twice as likely to be transferred for a psychiatric indication (43.5% vs 19.5%, P < .01).

Conclusions: Emergency pediatric transfers are uncommon in the United States; transfer rates are similar in urban and rural settings. Rural children have additional obstacles to care, especially in access to emergency mental health services. Programs to study and implement regionalization of care should consider diverse patient populations and target improvement in coordination of care, transfer times, and outcomes.

Keywords

access to care; health disparities; mental health; policy; utilization of health services