Improving pediatric burn care and identifying gaps in access to specialized treatment in Ontario
Dr. Eduardo Gus, a pediatric plastic surgeon in the Division of Plastic and Reconstructive Surgery at The Hospital for Sick Children, Toronto, and former Leong Centre Studentship Recipient, provides an update on his research focused on pediatric burn epidemiology in Ontario. He highlights ongoing barriers to accessing specialized burn care in the province, particularly for children in need of more advanced treatment.
Over the past decades, the annual number of new burn patients treated at The Hospital for Sick Children's burn centre has progressively increased. This raised the question: has the incidence of pediatric burns in Ontario risen, or does this trend reflect changes in how burn care is delivered in the province? Specifically, as specialized burn centres have been established to ensure severe burn patients receive the appropriate level of care, we were interested in determining whether children requiring specialized treatment were accessing these facilities. I explored this research question during my master's degree with the support of a Studentship Award from the Edwin S.H. Leong Centre for Healthy Children, which provided funding for the data analysis.
Our population-based repeated, cross-sectional study showed a 37% reduction in pediatric burn incidence in Ontario over the past two decades, suggesting that prevention efforts in the province have been largely successful and generally equitably implemented. However, we also identified certain groups of patients for whom the decline in burn incidence was less pronounced, highlighting areas where future prevention efforts can be targeted.
We also found that while treatment at non-specialized facilities decreased by 45%, the number of children treated at burn centres increased by 20% during the 20-year study period. Although more children are being treated in specialized burn centres, a majority of pediatric burns, including those that meet multiple indicators for specialized care, such as burns greater than 10% of the total body surface area, chemical and electrical burns, continue to be managed at non-specialized facilities. Our findings suggest that pediatric burn patients may be facing significant barriers - whether related to health system, hospitals, or practitioners, that prevent them from receiving treatment at specialized burn centres. A comprehensive publication on this work is forthcoming and will be released in the near future.
Our next steps involve identifying and addressing these barriers to improve access to burn centre care, ultimately supporting enhanced pediatric burn care delivery and promoting health equity for all children.
