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Educational interventions to alter pediatric emergency department utilization patterns
1Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
Insights
Educating parents about primary care providers and common pediatric illnesses did not reduce pediatric emergency department visits in this study. Further interventions are needed to change long-term emergency department utilization for minor illnesses.
Area of Science:
- Pediatric Emergency Medicine
- Health Services Research
- Public Health
Background:
- Pediatric emergency departments (PEDs) often manage minor illnesses, contributing to overcrowding and increased healthcare costs.
- Educating parents on primary care provider (PCP) utilization and common pediatric conditions is a potential strategy to reduce non-urgent PED visits.
Purpose of the Study:
- To evaluate the effectiveness of a one-time educational intervention aimed at reducing PED visits for minor pediatric illnesses.
- To test the hypothesis that parental education on PCP use and common pediatric illnesses decreases PED utilization.
Main Methods:
- A prospective, randomized controlled trial was conducted in an urban university hospital's PED.
- Parents of 130 children with minor illnesses were randomized into an intervention (education) or control group.
- Follow-up at 6 months assessed return visits to the PED via telephone and medical record review.
Main Results:
- No significant difference in return PED visits was observed between the intervention (30%) and control (26%) groups (P = .68).
- A majority of return visits in both groups were for minor illnesses (81% intervention, 69% control).
- Most parents identified a primary care provider, regardless of group assignment.
Conclusions:
- A single educational intervention in the PED setting does not significantly alter long-term emergency department utilization patterns for minor illnesses.
- More comprehensive educational strategies and improved access to primary care may be necessary to effectively reduce PED visits for non-urgent conditions.
Objective:
To test the hypothesis that educating parents about use of their primary care provider and providing information about common pediatric illnesses will reduce visits to the pediatric emergency department (PED).
Design:
Prospective, randomized, controlled trial conducted from September 1, 1993, to October 31, 1994.
Setting:
Pediatric emergency department of an urban university hospital.
Participants:
Parents of 130 patients seen in the PED for minor illness.
Interventions:
Subjects were randomized to intervention or control groups. Parents in both groups were interviewed about their child's health and use of health care services. The intervention group received education on pediatric health care issues; the control group received usual PED discharge instructions. Use of the PED by all subjects was tracked for 6 months by telephone follow-up and medical record review.
Main Outcome Measures:
Differences between the two groups in total number of return visits to the PED and return visits to the PED for minor illness.
Results:
Sixty-seven (97%) of the 69 patients in the intervention group and 56 (92%) of the 61 patients in the control group identified a primary care provider. At 6-month follow-up, 21 patients (30%) from the intervention group and 16 (26%) from the control group had returned to the PED (P = .68, chi 2). Seventeen (81%) of intervention group returnees to the PED had minor illness, as did 11 (69%) of control group returnees.
Conclusions:
A one-time educational intervention in the PED does not alter long-term emergency department utilization habits. More extensive education and greater availability of primary care providers may be needed to decrease use of the PED for minor illness.