| Title |
A tale of two systems: practice patterns of a single group of emergency medical physicians in Taiwan and China
|
|---|---|
| Published in |
BMC Health Services Research, September 2017
|
| DOI | 10.1186/s12913-017-2606-4 |
| Pubmed ID | |
| Authors |
I-Anne Huang, Tang-Her Jaing, Chang-Teng Wu, Chee-Jen Chang, Shan-Hsuan Hsia, Nicole Huang |
| Abstract |
The quality of pediatric emergency care has been a major concern in health care. Following a series of health system reforms in China, it is important to do this assessment of pediatric emergency care, and to explore potential influences of health care system. This study aimed to compare practice differences in treating children with respiratory illnesses in two emergency department (ED) settings within different health care systems: China and Taiwan. A pooled cross-sectional hospital-based study was conducted in two tertiary teaching hospitals in Xiamen, China and Keelung, Taiwan belong to the same hospital chain group. A team of 21 pediatricians rotated between the EDs of the two hospitals from 2009 to 2012. There were 109,705 ED encounters treated by the same team of pediatricians and 6596 visits were analyzed for common respiratory illnesses. Twelve quality measures in process and outcomes of asthma, bronchiolitis and croup were reported. Descriptive statistics and multiple logistic regression models were applied to assess. In order to demonstrate the robustness of our findings, we analyzed the data using an alternative modeling technique, multilevel modeling. After adjustment, children with asthma presented to the ED in China had a significantly 76% lower likelihood to be prescribed a chest radiograph, and a 98% lower likelihood to be prescribed steroids and discharged home than those in Taiwan. Also, children with asthma presented to the ED in China had significantly 7.76 times higher risk to incur 24-72 h return visits. Furthermore, children with bronchiolitis in China (Odds ratio (OR): 0.21; 95% Confidence interval (CI): 0.17-0.28) were significantly less likely to be prescribed chest radiograph, but were significantly more likely to be prescribed antibiotics (OR: 2.19; 95% CI: 1.46-3.28). This study illustrated that although high quality care depends on better assessment of physician performance, the delivery of pediatric emergency care differed significantly between these two healthcare systems after holding the care providers the same and adjusting for important patient characteristics. The findings suggest that the features of the health care system may play a significant role. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 40 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 40 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 7 | 18% |
| Student > Master | 5 | 13% |
| Student > Postgraduate | 4 | 10% |
| Student > Doctoral Student | 3 | 8% |
| Student > Ph. D. Student | 3 | 8% |
| Other | 8 | 20% |
| Unknown | 10 | 25% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 13 | 33% |
| Pharmacology, Toxicology and Pharmaceutical Science | 4 | 10% |
| Business, Management and Accounting | 3 | 8% |
| Nursing and Health Professions | 2 | 5% |
| Engineering | 2 | 5% |
| Other | 5 | 13% |
| Unknown | 11 | 28% |
Attention Score in Context
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#20,485,225
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Outputs from BMC Health Services Research
#7,186
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Outputs of similar age from BMC Health Services Research
#121
of 129 outputs
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