Frequent Emergency Department Use by Children

Area of Science:

• Pediatric Health
• Health Services Research
• Public Health

Background:

• Frequent emergency department (ED) use is a key quality improvement metric in pediatric healthcare.
• Understanding risk factors for high ED utilization is crucial for targeted interventions.

Purpose of the Study:

• To assess ED visit frequency in children based on demographic and health characteristics.
• To identify risk factors associated with high ED utilization among pediatric patients.

Main Methods:

• Analysis of 10 years of data (2005-2014) from a statewide hospital network in Rhode Island.
• Inclusion of all children aged 0-17 years utilizing network ED services.
• Geocoding of patient home addresses to evaluate neighborhood characteristics and distance to ED.

Main Results:

• 17,844 children had at least one ED visit between 2005-2014.
• In their peak year of use, 67.8% of children had one ED visit, while 5.2% had four or more.
• Age, race/ethnicity, language, insurance, medical complexity, neighborhood risk, and distance to ED were significantly associated with increased visit frequency.

Conclusions:

• Key risk factors for frequent pediatric ED use identified: age, race/ethnicity, language, insurance, medical complexity, neighborhood risk, and distance.
• Improving medical management for complex conditions is necessary.
• Addressing modifiable social determinants of health is essential to decrease frequent pediatric ED use.