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Pediatric use of emergency departments
Insights
Pediatric emergency departments are frequently used for primary care needs, such as infections and injuries, by children up to 16 years old. This study suggests strategies to better align services with patient demand.
Area of Science:
- Pediatric Emergency Medicine
- Health Services Research
- Primary Care
Background:
- Emergency departments (EDs) are crucial for acute care but are increasingly utilized for non-urgent primary care needs.
- Understanding the patterns of pediatric ED use is essential for optimizing healthcare resource allocation and service delivery.
Purpose of the Study:
- To examine the utilization of pediatric emergency services in urban teaching hospitals.
- To identify the types of health care problems, usage patterns, and disposition decisions for pediatric ED visits.
- To explore reasons for primary care issues presenting in the ED and suggest service improvements.
Main Methods:
- Cross-sectional survey utilizing a retrospective chart review design.
- Data collected from a 10% random sample of pediatric emergency visits over a 12-month period in two urban teaching hospitals.
- Trained research assistants extracted information on patient problems, visit timing (time of day, day of week), and disposition.
Main Results:
- Significant variations in presenting health care problems were observed based on age group, season, time of day, and day of week.
- Approximately 50% of pediatric ED visits were for primary health care issues, including soft tissue injuries, respiratory infections, and digestive tract infections.
- The study identified specific patterns in the types of problems and timing of visits.
Conclusions:
- A substantial proportion of pediatric emergency visits are for conditions that could potentially be managed in primary care settings.
- There is a need to improve the alignment between consumer demand for pediatric healthcare services and the available primary care resources.
- Strategies should be developed to enhance primary care accessibility and appropriateness, thereby reducing non-urgent ED utilization by children.
Abstract:
This cross-sectional survey examined the use of emergency services by children, from birth to 16 years of age, in two urban teaching hospitals. A retrospective chart survey design was used to obtain data on the prevalence of types of patient problems; the pattern of use, including time of day and day of week; and decisions regarding patient disposition. A random sample of 10% of the average monthly pediatric emergency visits was obtained for a 12-month period and relevant data were extracted by trained research assistants. Variation in the presenting health care problems by age group, season of the year, and by time of day and day of the week was found. Approximately 50% of visits involved such primary health care problems as soft tissue injuries, and respiratory and digestive tract infections. Possible reasons for this use of emergency departments for primary care needs are discussed and strategies are suggested for the provision of a better "fit" between consumer demand and health care services.