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Correlates of emergency room utilization in the first year of life
S Feigelman1, A K Duggan, C M Bazell
1Johns Hopkins University School of Medicine, Baltimore, Maryland.
Insights
Single mothers and children with recurrent illnesses were more likely to use emergency services. Parental worry about illness impacting child activity also predicted emergency room use, informing intervention strategies.
Area of Science:
- Pediatrics
- Health Services Research
- Social Determinants of Health
Background:
- Understanding factors influencing emergency room (ER) utilization in infants is crucial for optimizing healthcare resource allocation.
- Parental health beliefs and socioeconomic factors may play a significant role in healthcare-seeking behaviors for young children.
- Inner-city populations often face unique challenges impacting access to and utilization of primary care services.
Purpose of the Study:
- To investigate the correlates of emergency room use during the first year of life among inner-city children.
- To specifically examine the influence of parental health beliefs on emergency room utilization patterns.
- To identify predictive factors for emergency room use to inform intervention strategies.
Main Methods:
- A case-control study design was employed.
- Data collection involved structured interviews with families and medical record reviews.
- Analysis focused on comparing characteristics and health beliefs of emergency room users versus non-users.
Main Results:
- Infants utilizing the emergency room were more likely to be from single-mother households.
- Children with acute, recurrent medical conditions showed higher rates of emergency room use.
- Maternal worry about illness interfering with child's activities and specific health beliefs were associated with increased emergency room visits.
Conclusions:
- Maternal marital status, parental worry, and child's acute recurrent illnesses are significant predictors of emergency room utilization.
- Parental health beliefs, particularly concerning illness impact on child activity, are associated with emergency room use.
- The identified model provides a basis for developing targeted interventions to reduce unnecessary emergency room visits in similar populations.
Abstract:
We conducted a case-control study to examine the correlates of emergency room use in the first year of life, particularly the role of parental health beliefs, among the families of inner-city children enrolled in a hospital-based primary care program. Data was collected by structured interviews and by medical record review. Emergency room users were more likely to have single mothers and to have acute, recurrent medical conditions than were non-users. Health beliefs differed between groups by maternal report of worry about the kinds of illnesses that her child acquires. Emergency room use was predicted by: maternal marital status, maternal worry and concern that illness interferes with her child's activity, acute recurrent illnesses, hospitalization. This model may be applicable to other populations in designing intervention strategies to modify emergency room utilization.