Low-Acuity Pediatric Emergency Department Utilization: Caregiver Motivations

Area of Science:

• Pediatric Emergency Medicine
• Healthcare Utilization
• Public Health

Background:

• Emergency department (ED) overcrowding is exacerbated by nonurgent visits, leading to increased costs and wait times.
• Understanding caregiver motivations for nonurgent pediatric ED visits is crucial for developing effective interventions.
• Post-pandemic factors influencing these decisions require investigation.

Purpose of the Study:

• To identify the primary reasons caregivers bring children for nonurgent visits to the ED.
• To explore demographic differences in these reasons.
• To inform interventions promoting appropriate use of non-ED care for nonurgent conditions.

Main Methods:

• Surveys administered to caregivers of children with Emergency Severity Index (ESI) levels 3-5 visits at an urban pediatric hospital.
• Collected survey responses and anonymized demographic data from 602 participants.
• Analyzed responses based on respondent age, relation to child, child's race, insurance, and ESI level.

Main Results:

• Perceived urgency (74.2%) was the leading reason for nonurgent ED visits, often driven by a desire for rapid pain/discomfort relief (80.5%).
• A smaller proportion (13.6%) indicated their child was too ill for alternative care.
• Significant demographic variations were observed in the reasons cited for ED utilization.

Conclusions:

• The immediate desire for care significantly influences caregiver decisions for low-acuity pediatric ED visits.
• Potential socioeconomic and racial biases in care recommendations warrant further regional investigation.
• Targeted, community-based interventions addressing key drivers of low-acuity care seeking are most likely to reduce inappropriate ED use.