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Characteristics of paediatric frequent presenters at emergency departments: A whole-of-population study

Alexandra M Procter1, Angela Gialamas1, Rhiannon M Pilkington1

  • 1School of Public Health, Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia.

Journal of Paediatrics and Child Health
|August 21, 2020
PubMed

Insights

Frequent pediatric emergency department (ED) presenters, defined as children with four or more visits, represent a small group but account for a significant burden of care. These children often face socio-economic and health disadvantages, highlighting the need for targeted interventions.

Area of Science:

  • Public Health
  • Pediatric Emergency Medicine
  • Health Services Research

Background:

  • Pediatric emergency department (ED) utilization is a significant public health concern.
  • Understanding patterns of frequent ED use is crucial for resource allocation and intervention development.
  • Paediatric frequent presenters represent a disproportionate burden on healthcare systems.

Purpose of the Study:

  • To quantify the frequency of emergency department (ED) presentations among children.
  • To profile the socio-demographic, health, and presentation characteristics of paediatric ED frequent presenters.
  • To identify factors associated with recurrent ED visits in children.

Main Methods:

  • Population-based data linkage study of 55,921 children (aged 0-12 years) in South Australia.
  • Analysis of 100,976 public hospital ED presentations over a 12-month period.
  • Definition of frequent presenters as children with ≥4 recurrent ED presentations within 364 days.

Main Results:

  • Children with ≥4 recurrent ED presentations (4.4% of cohort) accounted for 15.4% of all paediatric ED visits.
  • Frequent presenters showed higher proportions of socio-economic and health disadvantage at birth compared to non-frequent presenters.
  • Nearly half of frequent presenters had at least one injury-related visit, and over a fifth had a visit related to a chronic condition.

Conclusions:

  • Frequent paediatric ED presenters, while a minority, impose a substantial burden on healthcare services.
  • Early socio-economic and health disadvantage, alongside childhood injury, are key characteristics of frequent presenters.
  • Targeted strategies addressing social disadvantage and childhood injury may effectively reduce the burden of paediatric ED presentations.
Abstract

Keywords:
data linkageemergency departmentfrequent presenterpaediatric

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