Arch Pediat Adol Med
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Arch Pediat Adol Med · Mar 1999
Comparative StudyImmature neutrophils in the blood smears of young febrile children.
To determine whether the immature neutrophil (band) count in the peripheral blood smear helps to distinguish young febrile children with bacterial or respiratory viral infections. ⋯ The band count in the peripheral blood smear does not routinely help to distinguish bacterial infections from respiratory viral infections in young febrile children.
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Arch Pediat Adol Med · Mar 1999
Supraventricular tachycardia in infancy: evaluation, management, and follow-up.
Supraventricular tachycardia (SVT) occurs frequently in infancy. However, some infants have no recurrences after the initial presentation of SVT, and approximately 30% of infants lose SVT inducibility by 1 year of age. ⋯ Control of SVT was possible in all patients. Clinical episodes of SVT were uncommon after discharge, yet most still had inducible SVT at 1 year of age. No data at presentation or initial esophageal EP study were predictive of the clinical course or of continued SVT.
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Arch Pediat Adol Med · Mar 1999
Comparative StudyAfter-hours telephone triage and advice in private and nonprivate pediatric populations.
To compare the content of after-hours medical triage and advice calls regarding private practice patients vs nonprivate practice patients and to assess caregiver compliance with advice resulting from these calls. ⋯ Compliance with recommended physician encounters was not significantly different (and lower than expected) in both groups of patients. Private practice patients are more likely to be referred to the ED. Calls for nonprivate practice patients are more frequent and these patients are more likely to be referred to their primary care source. This difference may be due to caregivers of patients from nonprivate practices seeking advice for less serious conditions. Physicians should address telephone medicine with caregivers proactively during health maintenance visits.
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Arch Pediat Adol Med · Mar 1999
Bridging the emergency medical services for children information gap.
To determine the epidemiological features of pediatric usage of prehospital emergency medical services (EMS) in a defined urban population. ⋯ Children using the Kansas City EMS were more likely to be infants, insured by Medicaid or uninsured, and live in low-income ZIP codes. Further study is needed to determine if this increased usage is due to greater incidence and severity of illness and injury, lack of transportation, lack of education, or other factors.
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Arch Pediat Adol Med · Feb 1999
The influence of chronic disease on resource utilization in common acute pediatric conditions. Financial concerns for children's hospitals.
To estimate the resource utilization in hospitalizations for common pediatric conditions or procedures involving patients with chronic disease vs those with no chronic disease and to develop an economic model of hospital per-patient profit (or loss) when insurance contracts fail to account for the presence of chronic disease. ⋯ Length of stay and charges are higher for everyday pediatric conditions or procedures when patients also have a chronic disease. If insurance contracts fail to account for chronic disease, then children's hospitals will realize significant financial losses, and over time this will lead to a decline in their financial viability, a reduction in quality, or a change in their mission.