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Trends in adult patients presenting to pediatric emergency departments

Cherisse Mecham1, Lucia Mirea1, Ryan Bode2

  • 1Phoenix Children's Hospital, United States of America.

The American Journal of Emergency Medicine
|August 4, 2020
PubMed

Insights

Adult emergency department visits are rising, with most patients not having complex chronic conditions (CCCs). However, the rate of adult CCC patients in pediatric emergency departments is increasing, particularly in older age groups.

Area of Science:

  • Pediatric Emergency Medicine
  • Adult Medicine Training
  • Healthcare Trends

Background:

  • Pediatric emergency departments (PEDs) increasingly see adult patients.
  • Adult patients in PEDs include those with complex chronic conditions (CCCs) and those without (non-CCCs).
  • Understanding trends in adult PED visits is crucial for healthcare training and resource allocation.

Purpose of the Study:

  • To describe recent trends in adult visits to pediatric emergency departments.
  • To analyze these trends by age subgroups and complex chronic condition (CCC) status.
  • To identify common diagnoses among adult patients in PEDs.

Main Methods:

  • Retrospective review of data from the Pediatric Health Information System (PHIS) for PED visits from 2013 to 2017.
  • Trend analysis of yearly visit rates for all adult visits, specific age subgroups (18-95 years), and CCC status.
  • Review of the most frequent diagnoses for each adult age group and CCC category.

Main Results:

  • Overall adult PED visit rates increased from 3.7% in 2013 to 4.2% in 2017.
  • While most adult PED patients were non-CCC, the rate of CCC patients increased significantly, especially in the 41-95 years age group (8.7% to 29%).
  • Common CCC diagnoses varied by age (e.g., sickle cell disease, cardiac pathology, hyperlipidemia), while non-CCC diagnoses included abdominal pain, pregnancy-related issues, and chest pain.

Conclusions:

  • Adult patient visits to PEDs are increasing, with non-CCC patients forming the majority.
  • A notable rise in adult patients with complex chronic conditions visiting PEDs was observed, particularly in older adults.
  • Findings can inform adult medicine training within Pediatric Emergency Medicine fellowships and continuing education.
Abstract

Keywords:
AdultsComplex chronic conditionsPediatric Health Information SystemPediatric emergency department

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