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[Repeat consultations in pediatric hospital emergencies]
A Pérez Sánchez1, M Begara De la Fuente, J Núñez Fúster
1Hospital U. Infantil Virgen del Rocío, Sevilla.
Insights
Children with frequent emergency room visits often come from low socioeconomic backgrounds and have common illnesses. Improved health education is needed to reduce unnecessary pediatric emergency care.
Area of Science:
- Pediatric Emergency Medicine
- Social Determinants of Health
- Healthcare Utilization
Background:
- Excessive utilization of hospital emergency services by pediatric populations presents a significant healthcare challenge.
- Understanding the social and clinical factors associated with frequent emergency room (ER) visits is crucial for resource allocation and intervention.
Purpose of the Study:
- To analyze the social and clinical characteristics of infants and children with excessive emergency service use.
- To identify factors contributing to repeated pediatric ER visits.
Main Methods:
- Retrospective analysis of clinical histories of 130 children (2 months to 10 years) with 10+ ER visits or 4+ visits in a year.
- Comparison with a control group of 270 children admitted during the same period.
- Statistical analysis to identify significant differences in social and clinical factors.
Main Results:
- Children with excessive ER use had significantly lower sociocultural levels (71%) and higher rates of serious social deprivation (17%) compared to controls (p < 0.05).
- Twenty percent had a history of febrile convulsions, and 33% had over four previous hospital admissions.
- Frequent consultations were associated with social deprivation, chronic conditions, multiple admissions, and proximity to the hospital (p < 0.05).
Conclusions:
- Pediatric patients with recurrent ER visits are predominantly from lower socioeconomic backgrounds.
- Many visits are for non-urgent, common conditions like upper respiratory tract infections, leading to excessive diagnostic testing.
- Targeted health education for these populations is essential to promote appropriate healthcare-seeking behaviors and reduce reliance on emergency services for primary care.
Abstract:
The objectives of this study were to analyze the social and clinical aspects of the infant and child population who excessively utilize the hospital emergency services. To this end, the clinical histories of 130 children admitted to a pediatric hospital have been analyzed. These children were between the ages of 2 months and 10 years and had 10 or more visits to the emergency room or had more than 4 visits during the same year. The control group was arbitrarily composed of 270 children admitted to the same service during the same period of time. We found that in the study group the sociocultural level was low in 71% and 17% had serious social deprivation (significant differences with the control population, p < 0.05). Twenty percent had at least one previous febrile convulsion (p < 0.001) and 33% had more than four hospital admissions. No significant differences in the number of urgent consultations were found between the different days of the week no between the different months. The most frequent diagnosis was upper respiratory tract infections. The number of consultations was higher (p < 0.05) in children with serious social deprivation, chronic pathology, multiple hospital admissions and whose home was near the hospital. We conclude that children with reiterative consultations to the hospital emergency services usually have a social level lower than the control group. Most of these consultations are caused by banal problems and the children are subjected to an excessive number of analytical and radiological tests. Therefore, adequate health education is necessary among these sociocultural level groups in order to avoid using the emergency services as primary attendance consultations.