Related Experiment Video
Updated: Oct 15, 2025
A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
Published on: April 7, 2023
Non-urgent emergency department attendances in children: a retrospective observational analysis
Rebecca M Simpson1, Colin O'Keeffe2, Richard M Jacques2
1School of Health and Related Research, The University of Sheffield, Sheffield, UK r.simpson@sheffield.ac.uk.
Insights
Many young children attending the emergency department (ED) have non-urgent attendances (NUAs). Targeted interventions for children under five, especially for out-of-hours care, could improve outcomes.
Area of Science:
- Pediatric Emergency Medicine
- Healthcare Management
- Public Health
Background:
- A significant proportion of pediatric emergency department (ED) visits are non-urgent attendances (NUAs).
- NUAs may be managed more appropriately in alternative healthcare settings.
- Understanding the patterns of NUAs is crucial for optimizing pediatric care delivery.
Purpose of the Study:
- To quantify the rates of NUAs and urgent attendances (UAs) in children presenting to the ED.
- To identify demographic and temporal factors associated with NUAs versus UAs.
- To inform targeted interventions for improving pediatric ED utilization.
Main Methods:
- Analysis of linked data from the CUREd research database for children's ED attendances in Yorkshire and Humber (April 2014-March 2017).
- Comparison of NUAs and UAs based on age, mode of arrival, time of arrival (in hours vs. out-of-hours), and deprivation.
- Examination of waiting, treatment, and total ED times for both NUA and UA groups.
Main Results:
- Younger children (aged 1-4 years) were more likely to have NUAs compared to infants under 1 year (OR 0.82).
- Non-urgent attendances were more likely during out-of-hours periods (OR 1.19).
- NUAs experienced shorter total ED times (median 98 min) compared to UAs (median 127 min).
Conclusions:
- A substantial percentage of pediatric ED visits are non-urgent.
- Children under five years represent a key demographic for targeted interventions.
- Enhancing accessible, timely care outside standard community hours is recommended to manage NUAs effectively.
Introduction:
A significant proportion of ED attendances in children may be non-urgent attendances (NUAs), which could be better managed elsewhere. This study aimed to quantify NUAs and urgent attendances (UAs) in children to ED and determine which children present in this way and when.
Methods:
Dataset extracted from the CUREd research database containing linked data on the provision of care in Yorkshire and Humber. Analysis focused on children's ED attendances (April 2014-March 2017). Summary statistics and odds ratios (OR) comparing NUAs and UAs were examined by: age, mode and time of arrival and deprivation alongside comparing summary statistics for waiting, treatment and total department times.
Results:
NUAs were more likely in younger children: OR for NUA in children aged 1-4 years, 0.82 (95% CI: 0.80 to 0.83), age 15 years, 0.39 (95% CI: 0.38 to 0.40), when compared with those under 1 year. NUAs were more likely to arrive out of hours (OOHs) compared with in hours: OR 1.19 (95% CI 1.18 to 1.20), and OOHs arrivals were less common in older children compared with those under 1 year: age 1-4 years, 0.87 (95% CI: 0.84 to 0.89) age 15 years, 0.66 (95% CI: 0.63 to 0.69). NUAs also spent less total time in the ED, with a median (IQR) of 98 min (60-147) compared with 127 min (80-185) for UAs.
Conclusion:
A substantial proportion of ED attendances in children are NUAs. Our data suggest there are particular groups of children for whom targeted interventions would be most beneficial. Children under 5 years would be such a group, particularly in providing accessible, timely care outside of usual community care opening hours.
