Did Emergency Department Visits in Infants and Young Children Increase in the Last Decade?

Abstract

ObjectivesThe aims of the study were to measure overall trends and to identify leading causes for pediatric emergency department (ED) visits among children aged 0 to 4 years.MethodsWe conducted an 11-year population-based open cohort study using health administrative data from 2008 to 2018 in Ontario, Canada. All ED visits were extracted from the National Ambulatory Care Reporting System, along with the most responsible cause of each visit. Annual ED visit rates were calculated per 100 children in each year. Overall and disease-specific rates for all children were calculated and then stratified by sex and age groups. Relative percentage change in rates between 2008 and 2018 were calculated and compared using standardized differences (SDIFs). Statistical significance of time trends was tested using Poisson regression.ResultsThis study included an average of 911,566 children from 2008 to 2018. All-cause ED visit rates increased by 28.2% from 2008 to 2018 (43.24–55.42 per 100, SDIF >0.1). Respiratory diseases were consistently the top cause of ED visits, and contributed to 1 in 3 ED visits in 2018. These respiratory conditions include asthma, asthma-related diseases (bronchiolitis, bronchitis, influenza, and pneumonia), and other respiratory diseases. Respiratory ED visit rates increased by 32.8% from 2008 to 2018 (11.51–15.28 per 100, SDIF <0.1), driven by a 46.4% (14.58–21.35 per 100, SDIF >0.1) increase among children younger than 1 year. There was a 78.0% increase in ED visits for bronchiolitis in infants (1.45–2.58 per 100, SDIF <0.1).ConclusionsRespiratory diseases like bronchiolitis among infants were the consistent leading cause for ED visits. All-cause ED visit rates among young children increased by 28.17% from 2008 to 2018.

One-year emergency department visits for children < 18 years of age, associated factors and frequency of primary general practitioner or pediatrician visits before: a French observational study (2018–19)

“…In England, close to 10% of children visited an ED four or more times in a year [ 29 ]. In Ontario (0–4 years: 43.2% to 55.4% from 2008 to 2018) [ 4 ]. Increase and excessive repetition of ED visits generates additional excess costs as inappropriate ED visits, which could be limited by actions on the factors associated with repeated ED visits justified or not [ 18 , 30 ].…”

“…Increase and excessive repetition of ED visits generates additional excess costs as inappropriate ED visits, which could be limited by actions on the factors associated with repeated ED visits justified or not [ 18 , 30 ]. Our study identifies factors that are more or less frequently reported associated with one ED visit or more such as younger age, male sex, low social status in the household or the area where the home is located, the existence of certain chronic pathologies, proximity to an ED [ 4 , 5 , 7 , 10 – 12 , 31 ].…”

“…In Korea, children under 19 accounted for 31% of ED visits in 2010 [ 2 ]. Other studies have reported an increase in ED visits by children under 15 in England (2007–17: 1.5%/year) and Ontario (0–4 years: 43.2% to 55.4% from 2008 to 2018) [ 3 , 4 ]. In Lombardy (Italy), attendance revealed that 27% of young people had visited the ED at least once in 2012, and 79% of them had done so for non-urgent reasons [ 5 ].…”