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[Evaluation of a pediatric emergency room: ten years later]
M G Pizzul1, G Canciani, G Messi
1Servizio di Pronto Soccorso e Primo Accoglimento, IRCCS Istituto per l'Infanzia, Trieste.
Insights
Pediatric Emergency Room (ER) use increased inappropriately, with more non-urgent visits. This trend, driven by family habits and poor practitioner relationships, necessitates changes to improve child care and reduce costs.
Area of Science:
- Pediatrics
- Health Services Research
Background:
- Pediatric Emergency Room (ER) utilization patterns are crucial for resource allocation and patient care.
- Previous research in 1981 indicated specific trends in ER usage among children.
Purpose of the Study:
- To evaluate the utilization of the pediatric ER in 1991.
- To compare current utilization with 1981 data and identify changes in visit appropriateness.
- To determine the primary causes of inappropriate ER visits.
Main Methods:
- A questionnaire study was conducted on 694 children utilizing the pediatric ER in 1991.
- Data were compared with a previous study from 1981.
- Causes for ER consultation were categorized, excluding true emergencies.
Main Results:
- A further decrease in urgent and appropriate visits was observed, alongside an increase in inappropriate visits.
- Visits for acute health problems were more frequently urgent and appropriate compared to recurrent problems.
- Key reasons for inappropriate ER visits included family custom, poor practitioner relationships, and hospital dependence.
Conclusions:
- Inappropriate utilization of the pediatric ER has increased, primarily due to suboptimal family-practitioner relationships.
- Addressing these issues is essential for cost reduction and enhancing the quality of pediatric care.
- Interventions should focus on improving primary care access and communication to reduce non-urgent ER visits.
Abstract:
Utilization of the pediatric Emergency Room has been evaluated during the year 1991, by a questionnaire study on 694 children. By comparison with a previous research in 1981 it was possible to identify a further decrease of urgent and appropriate visits with increase of those inappropriate. Visits were more frequently urgent of appropriate in case of acute health problems, inappropriate if related to recurrent problems. Without considering true emergencies, three main causes for ER consultation have been identified: family custom, inappropriate relationships with the practitioner, dependence on the hospital. In the first group of children most of the visits proved inappropriate. The study points out a further increase of inappropriate utilization of ER, due mainly to inappropriate relationships between the family and the practitioner. This has to be corrected to reduce costs and improve child care.