Families who seek care for the common cold in a pediatric emergency department

The Effect of a Community Intervention Trial on Parental Knowledge and Awareness of Antibiotic Resistance and Appropriate Antibiotic Use in Children

“…28 The decline in unmet expectations was more likely caused by parents having a better underlying understanding about judicious use of antibiotics and/or physicians better communicating reasons why antibiotics were not needed. Studies indicate that most parents primarily seek physician consultation to determine whether antibiotics are needed, 22,37,38 and patients' satisfaction is not correlated with receipt of antibiotics but with time spent by the clinician 24 and parents' subsequent understanding of treatment. 24,26 There are several limitations with this study.…”

The Many Faces of Access: Reasons for Medically Nonurgent Emergency Department Visits

“…Caretakers said they came to the ED because it was important to get reassurance that the child's situation was not serious or would not deteriorate and because "children can't tell you what's wrong, and parents want to make sure everything is OK." Some parents explained that they were hoping "to be told nothing's wrong" or "to make sure everything is OK." These findings correspond to the need for reassurance expressed by respondents in other studies. Researchers note that particularly in pediatric contexts-even when the medical condition may not be perceived as life-threatening or as needing immediate medical attention-parents and guardians express their need for a reassurance that their child's situation is not getting worse or that they are not at fault (Chande, Wyss, and Exum 1996;Mayefsky, El-Shinaway, and Kelleher 1991;Padgett and Brodsky 1992). Although the need for reassurance appeared more prominently in the pediatric sample, it was also found in adult ED visits.…”

“…Medically nonurgent visits are often referred to as inappropriate (Buesching et al 1985;Green and Dale 1992;Liggins 1993;Murphy 1998;Sanders 2000;Thompson, Kohli, and Brookes 1995;Walsh 1995) or characterized as a misuse (Afilalo and Guttman 1995) or even abuse (Foroughi and Chadwick 1989) of health care services. Whereas medical reasons presented by patients have been described as "trivial" (Mayefsky, El-Shinaway, and Kelleher 1991;Rubin and Bonnin 1995), researchers note that even ED visits initially assessed as nonurgent may result in hospitalization (Young et al 1996). In their attempt to control the volume of ED visits, managed care organizations have issued guidelines that proffer various definitions of medical emergencies and legitimate-presumably reimbursable -ED visits.…”

Understanding decisions leading to nonurgent visits to the paediatric emergency department: caregivers’ perspectives

“…Nonurgent use of the ED leads to overcrowding, long waiting periods, increased costs, high staff burden, caregiver dissatisfaction and lower quality of care for patients requiring urgent care. (6)(7)(8) Therefore, understanding the factors related to nonurgent ED use is paramount and may have far-reaching impact.…”

“…Previous studies on caregivers' perspectives revealed perceived need as a common reason; this perceived need is related to the perceived severity of the child's illness, (7,(9)(10)(11)(12)(13) the need to seek assurance on the course of the illness (7) and the expectation that medical tests, such as radiography, will be needed. (7,10,13) Caregivers' perceptions of primary healthcare providers are also a key contributing factor to the nonurgent use of paediatric EDs. Several studies indicated that caregiver dissatisfaction with primary healthcare providers was due to accessibility and scheduling issues, (9)(10)(11) as well as the perception that the quality of care given by primary healthcare providers is lower than that given at the ED.…”