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Examining the Appropriateness and Motivations Behind Low-Acuity Pediatric Emergency Department Visits

Maya Haasz, Daniel Ostro1, Dennis Scolnik2

  • 1Department of Pediatrics, Mackenzie Richmond Hill Hospital, Richmond Hill.

Pediatric Emergency Care
|September 5, 2018
PubMed

Insights

Many pediatric emergency department (PED) visits are for non-urgent issues, often due to limited access to primary care physicians during off-hours and difficulty obtaining tests. Addressing these barriers can reduce PED overcrowding.

Area of Science:

  • Pediatric Emergency Medicine
  • Healthcare Access
  • Public Health Policy

Background:

  • High patient volumes in pediatric emergency departments (PEDs) negatively impact care quality.
  • Understanding patient motivations for seeking care in PEDs is crucial for resource allocation and system improvement.

Purpose of the Study:

  • To assess the motivations behind pediatric emergency department visits that could have been managed by a primary care physician.
  • To identify factors contributing to the overuse of PEDs for non-urgent conditions.

Main Methods:

  • A convenience sample of 635 patients with high triage scores (4 or 5) presenting to a PED in 2011 was surveyed.
  • Patient visit motivations were assessed using a forced yes/no survey.
  • Visit appropriateness was evaluated using a modified DeAngelis tool.

Main Results:

  • 25% of high-acuity visits were deemed inappropriate according to DeAngelis criteria.
  • Perceived expertise of the tertiary care hospital (93.1%) and ease of accessing diagnostic tests (80.8%) were primary motivators for inappropriate visits.
  • Patients often had primary care physicians but faced limitations in accessing them during off-hours.

Conclusions:

  • Limited access to primary care physicians during off-hours and restricted availability of off-site testing contribute to PED overcrowding.
  • Public policy interventions should focus on improving primary care access and diagnostic test availability to reduce inappropriate PED utilization.
Abstract

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