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[Inadequate demand in a pediatric hospital emergency department: factors involved]
Insights
Many pediatric emergency departments (PED) are overwhelmed due to inappropriate use. This study identifies patient age, urban residence, and self-referral as key factors contributing to the overuse of these critical healthcare services.
Area of Science:
- Pediatric Emergency Medicine
- Healthcare Management
- Public Health
Background:
- Pediatric hospital emergency departments (PED) face significant overcrowding.
- The causes of this overcrowding, specifically inappropriate use, are not well understood.
- Evaluating factors contributing to the misuse of PED is crucial for optimizing healthcare resource allocation.
Purpose of the Study:
- To investigate the reasons behind the inappropriate utilization of pediatric hospital emergency departments.
- To identify sociodemographic and cultural factors associated with the overuse of PED.
- To analyze the relationship between patient characteristics and the decision to seek emergency care.
Main Methods:
- A representative sample of patients presenting to a regional hospital's PED was studied.
- Motivations for seeking care and sociodemographic/cultural factors were analyzed.
- Consultation appropriateness was assessed based on predefined criteria.
Main Results:
- Over half (52%) of patients had not contacted primary care prior to visiting the PED.
- A significant majority (79%) attended the PED on their own initiative.
- 65% of consultations were deemed inappropriate, with links to younger patient age (<1 year), urban residency, and self-referral.
Conclusions:
- Pediatric emergency departments are burdened by a high volume of inappropriate consultations.
- Patient age (infants), urban location, and self-initiated visits are significant predictors of inappropriate PED use.
- Understanding these predictive variables is essential for developing strategies to improve PED utilization and patient flow.
Background:
The massification of pediatric hospital emergency departments (PED) is due to bad use of the same by a large number of users. The causes related with this inadequate use have not been properly evaluated.
Methods:
A sample representative of the population demanding medical care in a PED of a regional hospital was studied with the motives and sociodemographic and cultural factors presumably related with this inadequate demand being analyzed.
Results:
52% of the cases had had no previous contact with the primary level of health care and 79% had gone to the PED on their own initiative. With regard to consultations, 65.0 +/- 4.8% were catalogued as inadequate and a statistical relation was found with the age of the patient (less than one year), place of residence (urban) and the arrival by initiative of the patients themselves.
Conclusions:
Pediatric hospital emergency departments receive a high number of inadequate consultations at the second level of health care. The importance of the age of the patient, accessibility of pediatric hospital emergency departments and who takes the initiative to come must be emphasized as predictive variables of the bad use of these pediatric departments.