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Rising paediatric emergency department use despite demographic decline: a 23-year analysis

Tommaso Bellini1, Marcello Mariani2, Giacomo Brisca3

  • 1Paediatric Emergency Room and Emergency Medicine Unit, Department of Emergency Medicine, Anesthesia and Critical Care, IRCCS Istituto Giannina Gaslini, Genoa, Italy tommasobellini@gaslini.org.

Emergency Medicine Journal : EMJ
|February 14, 2026
PubMed

Insights

Paediatric emergency department (PED) visits are rising despite fewer births, indicating increased use for non-urgent issues. This trend highlights the need for better primary care and patient education to manage demand.

Area of Science:

  • Public Health
  • Healthcare Management
  • Pediatrics

Background:

  • Global increase in paediatric emergency department (PED) attendance observed over two decades.
  • Rising demand in PEDs may stem from non-urgent conditions, not just true emergencies.
  • Understanding demographic impacts on PED use is crucial for health service planning.

Purpose of the Study:

  • To assess long-term trends in PED utilization and hospitalizations.
  • To analyze these trends in relation to declining birth rates in Liguria, Italy.

Main Methods:

  • Retrospective time-series analysis of PED visits and hospitalizations (2002-2024).
  • Utilized regional data on live births and pediatric population (≤14 years).
  • Calculated incidence rates relative to births and pediatric population; analyzed trends with correlation coefficients, excluding COVID-19 years.

Main Results:

  • Over 840,000 PED visits and 85,000 hospitalizations recorded.
  • Significant increase in PED visits per 1000 live births (regional and provincial).
  • Significant decrease in hospitalizations per 1000 PED visits and per 1000 pediatric residents.

Conclusions:

  • PED visits have disproportionately increased despite declining birth rates and pediatric population.
  • Increased visits are driven by non-urgent cases, indicating systemic inefficiencies.
  • Strategies like enhanced primary care, parental education, and innovative models are needed for sustainable PED care.
Abstract

Keywords:
Health Care Economics and Organizationsclinical governanceemergency departmentspediatric emergency medicine

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