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The Agency for Healthcare Research and Quality is one of eight Federal agencies interested in funding outcomes research on emergency medical services (EMS) for children. In a recent essay, AHRQ Acting Director Carolyn M. Clancy, M.D., and her colleagues Denise Dougherty, Ph.D., and Elinor Walker, provide an overview of accomplishments and challenges from the field of outcomes research, suggest important opportunities for applying existing methods to EMS for children, and identify potential research areas for current and future investigators. The article is based on a plenary talk delivered by Dr. Clancy at the AHRQ-sponsored conference, "Improving Emergency Medical Services for Children Through Outcomes Research: An Interdisciplinary Approach."
Based on previous data sources and new analyses of data from AHRQ's Medical Expenditure Panel Survey (MEPS) and Healthcare Cost and Utilization Project (HCUP), the authors conclude that children seek a full range of EMS for conditions that are not trivial, and it is critical that we strengthen our efforts to learn what works when children have a need for EMS. Previous research on EMS outcomes for children, some of which was supported by AHRQ and the Health Resources and Services Administration (HRSA), has examined aspects of both prehospital care—such as the effects on children's outcomes of using lights and sirens or various types of cardiopulmonary resuscitation and ventilation during emergency transport—and hospital-based care in the emergency department—including the impact of pediatric versus adult trauma care on outcomes and ways to improve the quality and efficiency of care in the emergency department.
Despite these important projects, research on EMS outcomes for children has been limited. Efforts to date have not covered the priorities for research on children's EMS that have been identified previously by expert committees.
Cross-cutting areas identified as priorities related to pediatric EMS outcomes research range from development and validation of injury and illness scoring scales and injury prevention strategies and outcomes to evaluation of the costs and effects of out-of-hospital EMS services for children. The authors would add to this list development of a conceptual framework that addresses the unique methodological issues inherent in pediatric EMS outcomes research; examination of outcomes such as discomfort, pain, symptom relief, function, and satisfaction; and incorporation of the perspective of families or other primary caregivers and payers.
See "The importance of outcomes research in pediatric emergency medicine," by Drs. Clancy and Dougherty and Ms. Walker, in the July 2002 Ambulatory Pediatrics 2(4), pp. 293-300.
Reprints (AHRQ Publication No. 02-R087) are available from the AHRQ Publications Clearinghouse.
Editor's Note: Select Child Health for more information on AHRQ's children's health research agenda and funding opportunities.
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