Determinants of nonurgent use of the emergency department for pediatric patients in 12 hospitals in Belgium

Abstract

Almost 40 % of all paediatric ED attendances did not require hospital expertise. The risk of an inappropriate use of ED by pediatrician patients is predominantly associated with organizational and cultural factors. Access, equity, quality of care, and medical human resources availability have to be taken into account to design financially sustainable model of care for those patients. Furthermore, future research is needed to explain reasons why parents visit ED rather than using of primary-care services.

Exploring parents’ reasons for attending the emergency department for children with minor illnesses: a mixed methods systematic review

“…Fourteen studies were conducted in the USA, three in Canada, two in the United Kingdom (UK), two in Australia, one in Belgium, one in Singapore and one in Lithuania. Sample sizes ranged from 1231 to 31179 participants with an overall total of 7561. Eight included studies collected data following triage while participants were waiting to be seen by a doctor 5 24 25 27 29 30 38 39.…”

“…Providing parents with knowledge about what constitutes urgent and non-urgent care for common childhood diseases would aid parents’ decision making in attending the ED 29 37. It has been recommended that increasing the insight and knowledge of parents in the appropriate use of healthcare services could improve the quality of care in ED, decrease inappropriate usage and reduce costs 9. Additionally, greater health literacy, or the provision of feedback on usage, could dissuade attendance.…”

“…The term ‘minor illness’ was operationally used by Butun and Hemingway8 as non-urgent cases that could be treated by simple medication, self-care or need no treatment. Recent figures on paediatric ED visits suggest around 40% (n=1244) were non-urgent in a study conducted across 12 hospitals in Belgium 9. Just over half (53%) of ED visits were categorised as least urgent in Australia,10 while in the USA between 37% and 60% of 25 million paediatric attendances were considered as non-urgent visits per annum 11 12.…”

Socio‐economic composition of low‐acuity paediatric presentation at a regional hospital emergency department

“…About 23 086 ED visits occurred between 2010 and 2013, and 32.4% of these visits were low acuity, resulting in costs to the health‐care system in excess of A$895 000–A$1 110 000 per year over the 4‐year study period. ED use for low‐acuity visits among paediatric patients is an international concern, with the proportions reported in various studies ranging from 15 to 90% . The costs estimated in this study are the costs that could have been saved if the children had presented at a GP clinic or other primary care centres.…”

“…The proportion of paediatric‐related low‐acuity ED visits ranges from 15 to 90% . Given that paediatric patients are a vulnerable population and require special care for growth and development, the continuous use of the ED for low‐acuity presentation places the child at an increased risk of poor continuity of care .…”