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[Pediatric primary care seen through a hospital emergency service]
M Sanchez Bayle1, J C Molina Cabañero, M de la Torre Espi
1Servicio de Urgencias, Hospital del Niño Jesús, Madrid.
Insights
Pediatric emergency room visits may stem from insufficient health education rather than primary care gaps. Many parents cited pediatrician availability and routine ER visits as reasons for seeking emergency care.
Area of Science:
- Pediatric Emergency Medicine
- Primary Care Evaluation
- Health Services Research
Context:
- Study conducted at Niño Jesus Hospital Emergency Room, analyzing 1,044 weekday morning pediatric patient visits.
- Investigated parental motivations for bypassing primary care physicians in favor of emergency services.
- Assessed the adequacy of prior diagnoses and treatments for pediatric patients presenting to the ER.
Purpose:
- To evaluate primary pediatric care's role in generating emergency hospital care demand.
- To understand parental reasons for seeking emergency care instead of consulting primary care physicians.
- To determine the primary drivers of pediatric emergency room utilization.
Summary:
- Adequate prior diagnosis/treatment was noted in 83.81% of cases. Only 14.1% of parents cited emergencies or worsening conditions.
- Key parental motivations included pediatrician's limited afternoon hours (35.89%) and systematic ER visits (20.91%).
- A significant portion (35.7%) of children received regular check-ups despite not being ill, suggesting potential over-utilization patterns.
Impact:
- Findings suggest that a lack of public health education, not primary care deficiencies, significantly contributes to pediatric emergency room demand.
- Highlights the need for improved patient education on appropriate healthcare seeking behaviors.
- Informs strategies for optimizing primary care accessibility and reducing non-urgent emergency department visits.
Abstract:
We have studied the procedures for taking care of the 1,044 patients who arrived in the Emergency Room at the Niño Jesus Hospital on weekday mornings, in order to evaluate the operation of primary pediatric care as the possible generator of the demand for emergency hospital care. We also took into account the motivations which the parents of the children gave for not having gone to their doctors. The diagnosis and/or prior treatment were considered adequate in 83.81% of cases, and in 64.63% of cases in which these were known for a fact. 35.7% of the children were periodically checked out by their doctors even though they were not ill. Among the motives given by the parents for going directly to the Emergency Room, only 5.69% and 8.41% respectively said that it was due to an emergency situation or a worsening of the patient's state. 35.89% pointed out that their pediatricians had afternoon hours, and 20.91% that they went to the Emergency Room systematically regardless of the problem. Only 10.27% said that they were unhappy with their doctor. From our data it would seem that the demand for emergency pediatric hospital care is due more to a lack of health education of the population than to deficiencies in primary care.