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Lisa Black

In a new policy statement, the American Academy of Pediatrics examines ways to improve safety when children are directly admitted into a hospital without first receiving care through an emergency department.

The statement, “Direct Admission to Hospital for Children in the United States,” published in the March 2023 Pediatrics (online Feb. 27), observes that approximately 2 million children and adolescents are admitted to hospitals in the United States, with hospital care accounting for more than 40% of all pediatric health care expenditures.

The AAP Committee on Hospital Care, after reviewing research and conducting interviews with parents of hospitalized children, details how to balance the benefits of direct admission with potential safety concerns.

Communication with families and between health care providers helps ensure that the child’s care is consistent, that tests are not duplicated and that families are informed, according to the statement.

The recommendations call for developing direct admission written guidelines; clear systems of communication between members of the health care team and with families; triage systems to identify patient acuity and disease severity; and identification of hospital resources needed to support direct admission systems of care. The AAP also recommends consideration of patient populations that may be at increased risk of adverse outcomes during the hospital admission process.


The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.

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