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A study of 'inappropriate' attendances to a paediatric Accident and Emergency Department
1Department of Public Health Medicine and Epidemiology, Queens Medical Centre, Nottingham.
Insights
A significant portion of children attending Accident and Emergency Departments (AEDs) do so inappropriately. This study found 30.1% of pediatric AED visits were unnecessary, often linked to adult perceptions rather than GP availability.
Area of Science:
- Pediatric Emergency Medicine
- Healthcare Utilization Studies
Background:
- 'Inappropriate' attendance to Accident and Emergency Departments (AEDs) is a recognized healthcare challenge.
- Previous research on inappropriate pediatric AED use is limited, necessitating further investigation.
Purpose of the Study:
- To investigate the extent and characteristics of inappropriate attendance at a children's Accident and Emergency Department (AED).
- To identify factors associated with inappropriate pediatric AED visits.
Main Methods:
- A study was conducted at a children's AED in Nottingham during September-October 1989.
- Data were collected via interviews with accompanying adults and review of medical records for a sample of pediatric patients.
- Attending physicians assessed attendance appropriateness using defined criteria.
Main Results:
- 30.1% of the studied pediatric patients were deemed inappropriate attenders.
- Inappropriate attendance was more prevalent in younger children, those from lower social classes, and those residing nearest to the hospital.
- No correlation was found between inappropriate attendance and general practitioner availability.
Conclusions:
- Perceptions of the accompanying adults significantly influence decisions for children to attend the AED.
- Interventions are needed to address and correct these perceptions to reduce unnecessary pediatric AED visits.
Abstract:
'Inappropriate' attendance to Accident and Emergency Departments (AEDs) has been shown in many studies to be a sizeable problem. However, only one previous study has investigated inappropriate attendance to these departments amongst children. In this paper we report an investigation of 'inappropriate' usage of a children's AED in Nottingham. Information was collected relating to a representative sample of children who attended this department during September and October 1989 by interviewing the adults accompanying them to the AED and by examining the children's AED medical records. Using defined criteria, the doctors treating each child within the AED assessed whether their attendance was 'appropriate' to the department. Nearly a third (30.1 per cent) of the patients studied were subsequently considered to be inappropriate attenders to this department. This proportion was highest amongst younger children, those from families of lower social class and those living closest to the hospital. 'Inappropriate' attendance was not found to relate to the availability of general practitioners. The reasons stated for choosing to attend the AED suggested that these attendances resulted from perceptions of the adult(s) accompanying the children to the department. In view of this finding, action is required to correct these perceptions, although it is recognized that this may be difficult to achieve.