Watching a child undergo the treatment and medical care they need to overcome an illness is daunting. A long and tiring hospital admission process doesn’t help.

Health care providers and parents constantly search for the best and most effective ways to treat children who need to go to the hospital. Direct admissions can streamline this process.

What Is Direct Admission?

A child who is sick enough may go to the hospital’s emergency department. There, doctors diagnose their health issues and decide whether to recommend further treatment. Direct admission offers an alternate route to getting admitted to the hospital.

Direct admission is when a patient goes to a hospital without going through its emergency department. The patient bypasses the ED and goes directly from a doctor’s office or urgent care center to an inpatient bed.

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What Are the Benefits of Direct Admissions for Kids?

Admitting a child to the hospital through direct admissions when they don’t need emergency treatment can offer many benefits. Bypassing the emergency department helps by:

  • Avoiding exposure to other ill patients. Newborn babies are especially susceptible to infections. Limiting their exposure to ill patients makes direct admission safer.
  • Reducing wait time. Emergency departments can get very busy, especially during the holiday season. Avoiding the unnecessary wait in an emergency department can allow your child to get the care they need faster.
  • Saving on unnecessary costs. Direct admission can help families avoid additional charges associated with visits to the emergency room. Furthermore, the process streamlines the flow of patients in the emergency department, making it more efficient.

Is Direct Admission Safe?

Many doctors are still studying the effectiveness of direct admissions for children.

Sylvia Choi, MD, FAAP, and Allison Fleischer, MD, are co-investigators of the Patient-Centered Outcomes Research Initiative (PCORI) study on direct admission.

This is a multicenter study involving other children’s hospitals, led by Dr. JoAnna Leyenaar, from Dartmouth. The study aims to address the safety and effectiveness of direct admission, comparing it with admissions via emergency departments.

In an interview with the UPMC Children’s Hospital of Pittsburgh’s podcast, That’s Pediatrics, Dr. Choi and Dr. Fleischer discussed people’s concerns regarding direct admission.

The doctors explained how their study has helped identify what diagnoses are most appropriate for direct admission and what its possible outcomes are.

Surprisingly, only one in four children admitted to hospitals go through a direct admission process.

Criteria for Direct Admission

For the PCORI study, a primary care provider evaluation, medical stability, and a failed outpatient treatment were the criteria for determining a patient’s eligibility.

Some diagnoses that fit Dr. Choi and Dr. Fleischer’s criteria include:

  • Dehydration.
  • Fever.
  • Pneumonia.
  • Nonspecific viral illnesses.
  • Skin and soft tissue infections without any abscess.
  • Urinary tract infection.

How It All Works

Direct admission starts when a pediatrician decides that a sick child should go to the hospital. The pediatrician then consults a doctor whose focus is caring for those who are already in the hospital.

After reviewing the child’s case, this doctor “accepts” them, working with nurses and other hospital staff to directly admit the child to the hospital.

Communication also becomes more efficient and straightforward as a child goes from their primary care provider’s office to the inpatient unit.

This also decreases the chances of losing information by going through the emergency department.

Families whose children have been directly admitted to the hospital have reported uniformly positive feedback. None of the children in the study needed to go to an intensive care unit.

Their care was efficient. Avoiding long waits in the emergency room can make getting care faster and easier.

Drs. Leyenaar, Choi, and Fleischer’s study shows that direct admission is a safe and efficient option for children who need to go to the hospital.

About Pediatrics

From nutrition to illnesses, from athletics to school, children will face many challenges growing up. Parents often will make important health care decisions for them. We hope to help guide both of you in that journey. UPMC Children’s Hospital of Pittsburgh is a national leader in pediatric care, ranking consistently on U.S. News & World Report’s Best Children’s Hospitals Honor Roll. We provide expert treatment for pediatric diseases, along well-child visits, urgent care, and more. With locations across Pennsylvania, Maryland, and West Virginia, you can find world-class care close to home. We also work closely with UPMC Magee-Womens Hospital, a national leader in care for newborns and their mothers. Our goal is to provide the best care for your children, from birth to adulthood and beyond. Visit our website to find a doctor near you.