Frequent Emergency Department Use by Children

Vivier, Patrick M.; Rogers, Michelle L.; Gjelsvik, Annie; Linakis, James G.; Schlichting, Lauren E.; Mello, Michael J.

doi:10.1097/pec.0000000000001859

Cited by 14 publications

(15 citation statements)

References 26 publications

(88 reference statements)

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“…Non-emergency patients sometimes visit the hospital at various times during the day due to parental anxiety [3,4]. Social and economic factors in the family, education, and health care awareness may all increase the incidence of emergency visits [5]. Furthermore, children classi ed as being in poverty had more emergency time hospital visits [6].…”

Section: Discussionmentioning

confidence: 99%

Height measurements to diagnose short stature and obesity during after-hours period are inefficient.

Matsumoto

Ushijima-Fuchino

Fujimoto

et al. 2022

Preprint

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Background: Pediatricians in Japan usually measure child body weight during medical examinations. However, they rarely measure child height. Furthermore, during examinations at night or on holidays they may not measure child height at all. There are no reports addressing the efficiency of pediatric height measurement during medical examinations, especially those taking place at night or on holidays. Our study asked whether height measurements and obesity index calculations during all pediatric visits were efficient. Methods: We analyzed data collected on patients between the ages of 3 and 10 years who visited a pediatrics department over a 1-month period. We divided the patients into four groups based on when they visited the department: 1) weekday-day, 2) weekday-early night, 3) weekday-late night, 4) holiday-day. The height and the body weight of all patients were measured. This analysis included 1101 patients. The numbers of patients visiting the hospital were 727, 176, 34, and 164 for daytime, early night, late night, and holiday visits, respectively. Resalts: There were no significant differences in ages of children visiting at different times (p=0.57). However, there were significant differences in height variation among children visiting at different times (p=0.008), with the late-night group being the most variable. There were no significant differences in the incidence of obesity (depend on body mass index (BMI)) among patients visiting at different times (p=0.44); however, significant variations were found for BMI among the patients, (p=0.03), being significantly lower for the late night group than the others. Conclusions: We conclude that using height measurement to detect short stature (SS) and calculating BMI to detect obesity is inefficient for children who visit hospital during emergency times.

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Section: Discussionmentioning

confidence: 99%

Height measurements to diagnose short stature and obesity during after-hours period are inefficient.

Matsumoto

Ushijima-Fuchino

Fujimoto

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…Non-emergency patients sometimes visit the hospital at various times during the day due to parental anxiety [5,6]. Social and economic factors in the family, education, and health care awareness may all increase the incidence of emergency visits [7]. Furthermore, children classi ed as being in poverty had more emergency time hospital visits [8].…”

Section: Discussionmentioning

confidence: 99%

Height Measurements to Diagnose Short Stature and Obesity During After-Hours Period is Inefficient

Matsumoto

Ushijima

Fujimoto³

et al. 2022

Preprint

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Background: Pediatricians in Japan usually measure child body weight during medical examinations. However, they rarely measure height. There are no reports addressing the efficiency of height measurement at night or on holidays. Our study asked whether height measurements and obesity index calculations during all pediatric visits were efficient. Methods: We analyzed data collected on patients between the ages of 3 and 10 years who visited a pediatrics department over a 1-month period. We divided the patients into four groups based on when they visited the department: 1) weekday daytime, 2) weekday Semi-night, 3) weekday Mid-night, 4) holiday. The height and the body weight of all patients were measured. This analysis included 1101 patients. The numbers of patients visiting the hospital were 727, 176, 34, and 164 for Day-time, Semi-night, Mid-night, and Holiday visits, respectively. Resalts: There were no significant differences in ages of children visiting at different times (p=0.211). However, there were significant differences in height among children visiting at different times (p=0.018), with the Mid-night group being the highest. There were no significant differences in the incidence of obesity among patients visiting at different times (p=0.44); however, significant variations were found for BMI %tile among the patients (p=0.03), being significantly lower for the Mid-night group than the others. Conclusions: We conclude that height measurement to detect short stature (SS) and calculating BMI to detect obesity is inefficient for children who visit hospital during emergency times.

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“…We were unable to delineate the specific number of ED visits in the past 12 months beyond 2 or more as some other studies have previously done. 3,5,7,29 This was due to data limitations because ED visits were operationalized by the National Survey of Children's Health survey as none, 1, or 2 or more in the last 12 months. Despite this, our results were consistent with prior studies, demonstrating similar risk factors associated with increased ED utilization.…”

Section: Limitationsmentioning

confidence: 99%

Do Unmet Health Needs Drive Pediatric Emergency Department Utilization?

et al. 2020

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Lack of access to basic health services is thought to increase emergency department (ED) utilization. This study assessed the relationship between unmet health care needs and pediatric ED utilization in the United States. Methods:The National Survey of Children's Health was used (2016-2017; n = 71,360). Parent/guardians reported number of ED visits and the presence of unmet health needs (medical, dental, mental health, vision, hearing, other) in the last 12 months. Associations were analyzed using multinomial logistic regression modeling and accounted for the weighting and complex survey design of the National Survey of Children's Health. Results:Children with 2 or more unmet health needs had 3.72 times (95% confidence interval, 2.25-6.16) risk of ≥2 ED visits when compared with those with 0 unmet health needs. This risk became nonsignificant when adjusted for race, ethnicity, age, insurance, having asthma, current medication status, health description, number of preventative health visits, and place to go for preventative health (aRR, 1.77; 95% confidence interval, 0.96-3.27). The adjusted association was also nonsignificant for specific types of unmet needs. Race, insurance status, age 0 to 3 years, current medication status, having asthma, ≥2 preventative visits, and poorer health were associated with ≥2 ED visits.Conclusions: Unmet health needs were not found to be a significant driving force for ED utilization. Other factors were found to be more strongly associated with it. Future studies to understand the perception, motives, and complex interaction of various factors leading to ED use in high-risk populations may optimize care for these children.

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Frequent Emergency Department Use by Children

Cited by 14 publications

References 26 publications

Height measurements to diagnose short stature and obesity during after-hours period are inefficient.

Height measurements to diagnose short stature and obesity during after-hours period are inefficient.

Height Measurements to Diagnose Short Stature and Obesity During After-Hours Period is Inefficient

Do Unmet Health Needs Drive Pediatric Emergency Department Utilization?

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