Factors Influencing the Decision to Attend a Pediatric Emergency Department for Nonemergent Complaints
Victoria Smith1, Majd Mustafa, Eric Grafstein
1From the *Department of Family Medicine, †Faculty of Medicine, and Departments of ‡Emergency Medicine and §Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.
Insights
Many parents bring children to the pediatric emergency department (PED) for non-urgent issues. A significant number were advised to visit the PED by healthcare providers, despite having a primary care physician.
Area of Science:
- Pediatric Emergency Medicine
- Healthcare Access and Utilization
- Health Services Research
Background:
- Pediatric emergency departments (PEDs) often manage nonemergent cases.
- Understanding parental decision-making for PED visits is crucial for resource allocation.
Purpose of the Study:
- To investigate factors influencing parents' decisions to seek pediatric emergency care for nonurgent concerns.
- To identify reasons for presentation to the PED for low-acuity conditions.
Main Methods:
- Cross-sectional survey conducted at a tertiary-care pediatric referral center.
- Caregivers of children triaged to low-acuity levels were surveyed.
- Descriptive statistics were used to analyze data on prior healthcare contact and reasons for visit.
Main Results:
- 32% of families contacted another healthcare provider before visiting the PED.
- 59% of those who contacted a provider were instructed to go to the PED.
- Top reasons for PED visits included hospital specialization, prior medical history, and proximity.
Conclusions:
- Less than half of patients with primary care physicians contacted them before an nonurgent PED visit.
- A majority of those who did contact a provider were directed to the PED.
- Healthcare provider recommendations significantly influence nonurgent PED utilization.
Objective:
The objective of this study was to explore the factors associated with parents' decisions to bring their children to the pediatric emergency department (PED) for nonemergent concerns.
Methods:
We conducted a cross-sectional survey at a tertiary-care, pediatric referral center emergency department. We surveyed caregivers of children triaged to low-acuity levels using the Pediatric Canadian Triage and Acuity Scale. We used descriptive statistics to report the proportion of patients who have a primary care physician, who attempted to contact any health care providers prior to coming to the PED, and other factors surrounding the decision to come to the PED.
Results:
We approached 340 families, of which 300 were enrolled (uptake rate, 88.2%). We found that 32% (95% confidence interval, 0.26-0.37) attempted to contact another health care provider prior to coming to the PED, and 59% (95% confidence interval, 0.48-0.69) of those respondents were specifically instructed to come to the PED. The top 3 reasons for coming to the British Columbia Children's Hospital PED were (1) that it specializes in children, (2) child has medical issues previously managed at the same hospital, and (3) closest location to patient.
Conclusions:
Despite the majority of patients having a primary care physician, less than half of them actually contacted these providers (or another health care provider) before presenting to the PED for their nonurgent illness or injury. Of these, nearly two thirds were specifically instructed to come to the PED by the health care provider in the community.
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