[Repeat visits in a pediatric emergency department]

The objective of this study was to characterize children who frequently use the pediatric emergency department.

This retrospective study selected children who consulted five times or more at the Pellegrin University Hospital emergency department in Bordeaux during the year 2006. We looked for risk factors for recurrent visits first in a comparative study and then conducted a phone survey with their GP.

Among the 157 frequent-user children, 30.6% suffered from a chronic disease (more than half of them regularly seeing CHU doctors). For the other 59.4%, the risk factors for recurrent visits were age (children under the age of 1 year account for 35% of frequent users), distance from home to hospital (71.3% live within a 10-km perimeter), parental worry (44%), a precarious socioeconomic family situation, and being a beneficiary of the CMU (universal free health care coverage for low-income individuals) (37.6%). These children consulted more for a medical pathology (81.9%) than for a surgical pathology (18.1%) and were more often hospitalized (53.3% were hospitalized at least once). The degree to which these consultations followed an emergency situation was the same for both groups (i.e., 25% true emergencies).

Approximately one-third of emergency department frequent-user children are children with a chronic disease, the others being young children, living close to the hospital, from unfavorable socioeconomic groups (using CMU health coverage), or with anxious parents.