Factors related to paediatric patients' emergency department utilization

Soliday, Elizabeth; Hoeksel, Renee

doi:10.1080/713690225

Cited by 11 publications

(9 citation statements)

References 4 publications

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“…Again, this is similar to what others have noted in that parents tend to overestimate the acuity of their child’s condition. 8,10,20 This tendency could be addressed through the development of interventions that ensure parents are provided accurate anticipatory guidelines for their child’s health. This information needs to be provided in a culturally appropriate and understandable manner, keeping the health literacy of caregivers and patients in mind.…”

Section: Resultsmentioning

confidence: 99%

“…Scheduling an appointment with the PCP during business hours can prove to be challenging for working parents who instead may find the 24-hour availability of the ED a more advantageous option as it can be accessed when the clinic is closed or if after-hours PCP appointments are unavailable. 1,10,16,17 Furthermore, parental perceived difficulty in getting to the PCP office, reliance on public transportation, and living in close proximity to an ED or community health center also contribute to the convenience seen in utilizing the ED regardless of severity. 5,20,21 …”

Section: Introductionmentioning

confidence: 99%

“…Several studies examining the perceptions of parents and caregivers of non-urgent ED pediatric patients note their tendency to overestimate the acuity of the child’s condition. 8,10,20 With respect to distinguishing between the ED and a PCP clinic visit, some respondents made no such distinction and instead saw both venues as equally appropriate sources of care for minor problems. 16 …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A Profile of Nonurgent Emergency Department Use in an Urban Pediatric Hospital

Kubicek¹,

Liu²,

Beaudin³

et al. 2012

Pediatric Emergency Care

103

104

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Objectives This study was designed to develop a descriptive profile of parents and caregivers who bring their children to the emergency department for non-urgent issues as well as exploring the reasons for presenting to an urban hospital pediatric emergency department for non-urgent conditions. Such work is necessary in order to develop effective interventions. Methods A total of 106 parents/caregivers whose child was triaged with a non-emergent/urgent condition completed a 15–20 minute computerized survey (English and Spanish) in an urban pediatric emergency department. Results The majority of respondents described themselves as Latino (76%) and foreign-born (62%). About half (49%) reported having an annual income of less than $20,000 and 43% of respondents did not have health insurance for themselves. Almost all (95%) of the index children had a primary care physician and health insurance. In spite of being triaged as non-urgent, over half (63%) described their child’s condition as “very” or “extremely” urgent. About half of the respondents reported not receiving basic information on childhood illnesses from their child’s doctor. Reasons for non-urgent visits seemed to revolve around issues of convenience and perception of quality of care. Conclusions Interventions should focus on health literacy and ensure that parents are provided relevant and accurate education on pediatric illnesses and common safety concerns; by increasing parental education on pediatric health, parents may be better able to assess acuity of their child’s health issues.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A Profile of Nonurgent Emergency Department Use in an Urban Pediatric Hospital

Kubicek¹,

Liu²,

Beaudin³

et al. 2012

Pediatric Emergency Care

103

104

View full text Add to dashboard Cite

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“…The Barriers to Health Care Scale (BHCS) is a 16‐item measure developed to assess caregiver perceptions of barriers to routine service use and compliance in relation to their child's SCD. The items on the BHCS were derived from previous research assessing barriers to adherence (Soliday & Hoeskel 2001; Witherspoon & Drotar 2006). Examples of barriers include transportation problems, insurance or financial problems, difficulty getting medication and time constraints.…”

Section: Methodsmentioning

confidence: 99%

The relation between health‐related quality of life, treatment adherence and disease severity in a paediatric sickle cell disease sample

Fisak

Belkin

Lehe

et al. 2011

Child

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“…Similarly, service users often report using the ED because other careeither general practice or urgent careis not available. 83,95,156,[169][170][171][172][173] A study from the USA reported that participants initially tended to tolerate symptoms until pain increased to a level at which self-care was no longer possibleand when non-emergency care settings were full. 83 A lack of availability of urgent care may result in 'urgent cases' becoming emergency ones.…”

Section: Ambiguous Organisational Arrangementsmentioning

confidence: 99%

Sense-making strategies and help-seeking behaviours associated with urgent care services: a mixed-methods study

Turnbull

McKenna

Prichard

et al. 2019

Health Serv Deliv Res

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BackgroundPolicy has been focused on reducing unnecessary emergency department attendances by providing more responsive urgent care services and guiding patients to ‘the right place’. The variety of services has created a complex urgent care landscape for people to access and navigate.ObjectivesTo describe how the public, providers and policy-makers define and make sense of urgent care; to explain how sense-making influences patients’ strategies and choices; to analyse patient ‘work’ in understanding, navigating and choosing urgent care; to explain urgent care utilisation; and to identify potentially modifiable factors in decision-making.DesignMixed-methods sequential design.SettingFour counties in southern England coterminous with a NHS 111 provider area.MethodsA literature review of policy and research combined with citizens’ panels and serial qualitative interviews. Four citizens’ panels were conducted with the public, health-care professionals, commissioners and managers (n = 41). Three populations were sampled for interview: people aged ≥ 75 years, people aged 18–26 years and East European people. In total, 134 interviews were conducted. Analyses were integrated to develop a conceptual model of urgent care help-seeking.FindingsThe literature review identified some consensus between policy and provider perspectives regarding the physiological factors that feature in conceptualisations of urgent care. However, the terms ‘urgent’ and ‘emergency’ lack specificity or consistency in meaning. Boundaries between urgent and emergency care are ill-defined. We constructed a typology that distinguishes three types of work that take place at both the individual and social network levels in relation to urgent care sense-making and help-seeking.Illness workinvolves interpretation and decision-making about the meaning, severity and management of physical symptoms and psychological states, and the assessment and management of possible risks. Help-seeking was guided bymoral work: the legitimation and sanctioning done by service users.Navigation workconcerned choosing and accessing services and relied on prior knowledge of what was available, accessible and acceptable. From these empirical data, we developed a model of urgent care sense-making and help-seeking behaviour that emphasises that work informs the interaction between what we think and feel about illness and the need to seek care (sense-making) and action – the decisions we take and how we use urgent care (help-seeking).LimitationsThe sample population of our three groups may not have adequately reflected a diverse range of views and experiences. The study enabled us to capture people’s views and self-reported service use rather than their actual behaviour.ConclusionsMuch of the policy surrounding urgent and emergency care is predicated on the notion that ‘urgent’ sits neatly between emergency and routine; however, service users in particular struggle to distinguish urgent from emergency or routine care. Rather than focusing on individual sense-making, future work should attend to social and temporal contexts that have an impact on help-seeking (e.g. why people find it more difficult to manage pain at night), and how different social networks shape service use.Future workA whole-systems approach considering integration across a wider network of partners is key to understanding the complex relationships between demand for and access to urgent care.Study registrationThis study is registered as UKCRN 32207.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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Factors related to paediatric patients' emergency department utilization

Cited by 11 publications

References 4 publications

A Profile of Nonurgent Emergency Department Use in an Urban Pediatric Hospital

A Profile of Nonurgent Emergency Department Use in an Urban Pediatric Hospital

The relation between health‐related quality of life, treatment adherence and disease severity in a paediatric sickle cell disease sample

Sense-making strategies and help-seeking behaviours associated with urgent care services: a mixed-methods study

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