Outpatient pediatric burns: Using mapping to detect geographic areas at risk

Academic Article

Abstract

  • Objectives. To determine the demographics, external causes and compliance rate of pediatric burn injuries not requiring hospitalization and to perform a geographic analysis on pediatric burn injuries presenting to the emergency department. Setting and sample. Patients from Jefferson County, Alabama, presenting to The Children's Hospital of Alabama Emergency Department for an incident burn not requiring admission. Design. A retrospective review of medical records was conducted on all incident outpatient burn injuries in patients less than 15 years of age who resided in Jefferson County (n = 402) between January 1, 1993 and December 31, 1993. Methods. Descriptive statistics and the Chi-square test for independence were performed. Incidence density ratios for each zip code area in the county were calculated, and the incidence for each zip code area was mapped. Results. The overall incidence in Jefferson County for our study population was 2.7/1000 child years and the zip code area with the highest incidence was South Highland with 11.5/1000 child years (4.5 times that of the other zip areas in the county). One hundred and thirty patients (32%) did not complete the recommended follow-up care. Patients with Medicaid or no insurance had a higher 'lost to follow-up' rate than did patients with private insurance. The number of visits and the charges were both associated with increased severity. Implications for practice. Demographics and geographic data are defined for the outpatient pediatric burn injuries. Since uninsured and Medicaid populations are less likely to complete follow-up, interventions should be planned to ensure complete care and recovery of these burn victims. There is a need for an emergency department based surveillance system to further delineate information regarding this patient population as well as to evaluate the impact of follow-up visit non-compliance. Mapping of areas of highest incidence assists in delineating areas to target for intervention.
  • Published In

    Author List

  • Monroe KW; King W; Nichols MH; Breaux C W J
  • Start Page

  • 399
  • End Page

  • 406
  • Volume

  • 4
  • Issue

  • 4