Pediatric emergency department utilization in the 1970s

An analysis was undertaken of 8,470 visits to a pediatric emergency department (ED) over a three-month period during 1975-76. The ED was busiest in the evening and on weekends. Visits were overwhelmingly for acute conditions, which varied seasonally. Very young children accounted for a large proportion of visits (22.3% less than 1 year old, 47.0% less than 3 years old). The proportion of very young children increased as the hour of day got later. Overall, 7.3% of visits resulted in admission to the hospital, and 10% of children less than 1 year old were admitted. Admission rates were significantly higher on the day and night shifts than in the evenings, and rates were higher on weekdays than on weekends. Visits were mainly by children living in areas near the hospital, and children from the most distant areas were significantly more likely to be admitted than those from the nearest areas. The authors conclude that the documented ED usage patterns reflect the conditions of the children seen (age, medical problems, and severity of illness) and diminished availability of other services on weekends and evening. This indicates reasonable utilization of medical services and suggests the need for non-ED sources of care at times of peak ED use. These ED usage patterns in the 1970s are similar to those described in the 1960s, and together with the earlier data they provide a basis for comparison of utilization patterns during the current period of rapidly changing health-service reimbursement schemes.