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Vulnerable child syndrome, parental perception of child vulnerability, and emergency department usage
Patricia L Chambers1, E Melinda Mahabee-Gittens, Anthony C Leonard
1Division of Emergency Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA. patricia.chambers@cchmc.org
Insights
Children with higher parental perception of child vulnerability (PPCV) visited the emergency department (ED) more often. Identifying risk factors for high PPCV can help families with Vulnerable Child Syndrome (VCS) dynamics.
Area of Science:
- Pediatric healthcare
- Child psychology
- Family medicine
Background:
- Vulnerable Child Syndrome (VCS) characterizes children perceived as high-risk for health and developmental issues.
- Families affected by VCS dynamics frequently utilize healthcare services, leading to increased resource use.
Purpose of the Study:
- To investigate the association between Vulnerable Child Syndrome (VCS), parental perception of child vulnerability (PPCV), and emergency department (ED) visit frequency.
- To identify risk factors contributing to higher perceived child vulnerability.
Main Methods:
- Parents of children aged 1-15 presenting with nonurgent complaints to a pediatric ED were surveyed.
- The Vulnerable Child Scale measured PPCV, categorizing children into high (score <40) and low (score ≥40) PPCV groups.
- Outcomes included ED visit frequency and PPCV assignment.
Main Results:
- 17% of the 351 children studied had high PPCV.
- Children with high PPCV had a statistically significant increase in ED visits and hospital admissions compared to those with low PPCV.
- Several factors, including pregnancy/delivery issues and child/parent mental health problems, were associated with high PPCV.
Conclusions:
- Higher parental perception of child vulnerability is linked to increased emergency department utilization.
- Identifying risk factors associated with high PPCV is crucial for understanding and potentially intervening in Vulnerable Child Syndrome (VCS) dynamics.
- Further research into interventions for families exhibiting VCS dynamics is recommended.
Background:
Vulnerable child syndrome (VCS) describes children perceived to be at risk for behavioral, developmental, or medical problems. Families with the dynamics of VCS overuse health care resources with frequent visits to doctors' offices.
Objective:
The objective of the study was to explore the relationship between VCS, parental perception of child vulnerability (PPCV), and frequency of emergency department (ED) visits.
Design/Methods:
Parents of patients 1 to 15 years old presenting with nonurgent complaints to a pediatric ED were eligible. Participants completed questionnaires in which the Vulnerable Child Scale was used to generate a measure of PPCV. Primary outcomes included number of ED visits and PPCV assignment. Children were divided into 2 PPCV groups by Vulnerable Child Scale score: less than 40 (high PPCV) versus 40 or greater (low PPCV). The cutoff point was chosen as 1 SD (7.3) from the sample mean (46.8) on the vulnerable end of the scale (low scores).
Results:
The mean ages of the 351 parents and children were 30 (SD, 7.7) years and 5 (SD, 3.9) years, respectively; 17% of children had high PPCV. Eleven variables differed statistically between subjects with high and low PPCV including number of ED visits and hospital admissions, excellent reported child health, pregnancy problems, delivery problems, child mental health problems, parent mental health problems, and child developmental problems.
Conclusions:
Our results reveal that children with higher PPCV had an increased number of ED visits, and risk factors for higher perceived vulnerability scores were identified. Future investigation on ways to intervene with families with the dynamics of VCS may be warranted.
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