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Characteristics of paediatric frequent presenters to an Australian emergency medicine network

Donna Markham1, Andis Graudins2,3

  • 1Allied Health, Monash Health, Melbourne, Victoria, Australia.

Journal of Paediatrics and Child Health
|June 22, 2013
PubMed

Insights

Frequent paediatric emergency department (ED) presenters are more likely to be female, require hospital admission, and present with complex health needs, including mental health issues. Addressing their holistic well-being can reduce reliance on acute care.

Area of Science:

  • Pediatric Emergency Medicine
  • Health Services Research
  • Public Health

Background:

  • Frequent presenters (FPs) in pediatric emergency departments (EDs) represent a significant healthcare challenge.
  • Understanding the characteristics of these patients is crucial for developing targeted interventions.
  • Previous studies have highlighted the complexity of care needs for pediatric FPs.

Purpose of the Study:

  • To characterize frequent pediatric emergency department (ED) patients (FPs) in an Australian health service.
  • To compare the demographic and clinical characteristics of FPs with non-frequent presenters (NFPs).
  • To identify specific health conditions and care needs associated with frequent ED use in children.

Main Methods:

  • Retrospective chart review of pediatric patients (≤18 years) presenting to Monash Health EDs.
  • Data collected over a 12-month period (March 2009-March 2010).
  • Defined FPs as ≥8 presentations and NFPs as ≤5 presentations during the study period; compared characteristics.

Main Results:

  • 130 pediatric FPs accounted for 839 admissions, compared to 34,262 NFPs with 46,043 admissions.
  • FPs were more likely to be female, use ambulances, and be admitted to hospital.
  • FPs had higher rates of admission for mental health, oncology, neurology, respiratory, and psychiatric conditions, while NFPs more commonly presented with injuries.

Conclusions:

  • Pediatric FPs are a vulnerable group requiring complex, multidisciplinary care.
  • A holistic approach is essential to address the underlying reasons for frequent ED attendance.
  • Integrating non-ED services and focusing on wellness/self-management can reduce acute care reliance for chronic conditions.
Abstract

Keywords:
complex health-care needemergency departmentfrequent presenterpaediatricresource

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