Application of pediatric five-level triage system and resource utilization in emergency department

Abstract

Objective To explore the resources utilization in emergency under the implementation of pediatric five-level triage system and give reference for large tertiary emergency department (ED) in China. Methods In March 2015, the hospital information system platform was used to screen newly patients who visited internal emergency department, collect diagnosis and treatment items, calculate the cost produced in ED. The resource utilization was compared between the levels in the triage system. Results Out of the enrolled 7 010 cases, the major complaints were fever, cough and vomiting; 5 cases in Level-1 (0.1%), 70 cases in level-2 (1.0%), 3 416 cases in level-3 (48.7%), 3 418 cases in level-4 (48.8%), 101 cases in level-5 (1.4%); the average length of stay in emergency department (1-5 level): 65.6 min, 141.2 min, 73.1 min, 58.5 min, 48.3 min; the total cost in ED was consisted of diagnostic cost and treatment cost, 38.02% and 61.98% respectively. The average costs of 75 cases in level 1 and 2 were 691.14 Yuan, the average costs of 3 416 cases in level 3 were 182.92 Yuan, the average costs of 3 418 cases in level 4 were 187.87 Yuan, the average costs of 101 cases in level 5 were 101.66 Yuan. The ED diagnostic cost and treatment resource were used according to the severity assessed by the five-level triage system. The laboratory investigation costs made the most part of the diagnostic resource utilization, 83.16% children with fever took the blood routine examination. The costs of oral medicine accounted for the most proportion of treatment resource utilization. Conclusions The five-level triage system, not only help triage nurses to screen the critically ill children, but reflect the ED resource utilization. It may indicate that the children with fever in the pediatric emergency department can take routine blood test in advance, in order to reduce the emergency detention time, make more efficient use of emergency resources. Key words: Child; Emergency triage; Resource utilization; Economic cost