Frequency of pregnancy testing among adolescent emergency department visits.

TitleFrequency of pregnancy testing among adolescent emergency department visits.
Publication TypeJournal Article
Year of Publication2013
AuthorsGoyal M, Hersh A, Luan X, Mollen C, Localio R, Trent M, Zaoutis TE
JournalAcad Emerg Med
Volume20
Issue8
Pagination816-21
Date Published2013 Aug
ISSN1553-2712
KeywordsAdolescent, Cross-Sectional Studies, Emergency Service, Hospital, Emergency Treatment, Female, Humans, Logistic Models, Pregnancy, Pregnancy Tests, Retrospective Studies, United States, Young Adult
Abstract

OBJECTIVES: The objective was to estimate the frequency of pregnancy testing among adolescent emergency department (ED) patients and to determine factors associated with testing.

METHODS: This was a retrospective cross-sectional study using the National Hospital Ambulatory Medical Care Survey (NHAMCS) from 2005 through 2009 of ED visits by females ages 14 to 21 years. The frequency of pregnancy testing among all visits was estimated for potential reproductive health complaints and for those associated with exposure to potentially teratogenic radiation. Multivariable logistic regression modeling was performed to calculate adjusted probabilities and odds ratios (ORs) with 95% confidence intervals (CIs) to evaluate factors associated with pregnancy testing by patient characteristics.

RESULTS: The authors identified 11,531 visits, representing an estimated 41.0 million female adolescent ED visits. Of these, 20.9% (95% CI = 19.3% to 22.5%) included pregnancy testing. Among visits for potential reproductive health complaints and those associated with exposure to potentially teratogenic radiation, 44.5% (95% CI = 41.3% to 47.8%) and 36.7% (95% CI = 32.5% to 40.9%), respectively, included pregnancy testing. Among the entire study population, we found statistically significant differences in pregnancy testing by age, race or ethnicity, hospital admission, and geographic region (p < 0.001 for all).

CONCLUSIONS: A minority of female adolescent ED visits included pregnancy testing, even if patients presented with potential reproductive health complaints or received exposure to ionizing radiation. Small but statistically significant differences in pregnancy testing rates were noted based on age, race or ethnicity, ED disposition, and geographic region. Future studies should focus on designing quality improvement interventions to increase pregnancy testing in adolescent ED patients, especially among those in whom pregnancy complications or the risk of potentially teratogenic radiation exposure is higher.

DOI10.1111/acem.12186
Alternate JournalAcad Emerg Med
PubMed ID24033625
PubMed Central IDPMC3775011
Grant ListK23 HD070910 / HD / NICHD NIH HHS / United States
K23 HD070910-01 / HD / NICHD NIH HHS / United States