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

Alele, Faith; Callander, Emily; Emeto, Theophilus I.; Mills, Jane; Watt, Kerrianne

doi:10.1111/jpc.14079

Cited by 6 publications

(20 citation statements)

References 26 publications

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“…A detailed analysis of the emergency department triage scores showed non-urgent visits to be frequent with over 80% in asylum-seeking children. This proportion is considerably higher than in previous reports of 30-40% of non-urgent visits in pediatric emergency care centers in Canada and Australia [19,34], 40% in Belgium and Italy [35,36] and 60% in the United States [37] . However, the tendency to provide primary care by tertiary health care institutions is described as global problem and one reason for growing health expenses [20].…”

Section: Discussioncontrasting

confidence: 61%

Preventable admissions and emergency-department-visits in pediatric asylum-seeking and non-asylum-seeking patients

Brandenberger

Bozorgmehr

Vogt

et al. 2020

Int J Equity Health

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Background: Migrant health has become an essential part of public health. According to the World Health Organization, many health systems in Europe have not yet adapted adequately to the needs of asylum-seekers, which might result in untimely and inefficient health care for asylum-seeking patients. The aim of this study was to assess the number of preventable hospital admissions and emergency department visits in asylum-seeking and non-asylum-seeking pediatric patients. Methods: This is a retrospective, hospital-based study. The study was done at the University Children's Hospital Basel in Switzerland. Patients admitted or presenting to the emergency department were included and split into the groups of asylum-seeking and non-asylum-seeking patients. All admissions and emergency-department visits were extracted from the administrative electronic health records from 1st Jan 2016-31st Dec 2017. The main outcome was the proportion of admissions due to ambulatory-caresensitive conditions (which refer to conditions for which admission can be prevented by early interventions in primary care) in asylum-seeking and non-asylum-seeking patients. Ambulatory-care-sensitive conditions were defined by a validated list of ICD-10 codes. The secondary objective was to assess the number of preventable emergency-department visits by asylum-seeking patients defined as proportion of visits with a non-urgent triage score. Results: A total of 75′199 hospital visits were included, of which 63′405 were emergency department visits and 11′794 were admissions. Ambulatory-care-sensitive conditions accounted for 12.1% (18/149) of asylum-seeking and 10.9% (1270/11645) of non-asylum seeking patients' admissions. Among the emergency department visits by asylum-seeking patients, non-urgent conditions accounted for 82.2% (244/297). Conclusions: Admissions due to ambulatory-care-sensitive conditions are comparable in asylum-seeking and nonasylum-seeking children, suggesting few delayed presentations to ambulatory care facilities. Strategies to prevent nonurgent visits at pediatric emergency department facilities are needed.

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Section: Discussioncontrasting

confidence: 61%

Preventable admissions and emergency-department-visits in pediatric asylum-seeking and non-asylum-seeking patients

Brandenberger

Bozorgmehr

Vogt

et al. 2020

Int J Equity Health

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“…[9][10][11][12][13] In contrast, in Queensland Australia, Williams et al 14 found that although presentations at a major metropolitan paediatric hospital ED were multifactorial, socio-economic factors did not contribute to the presentations. Although Alele et al 15 reported on a large data set collected over a 4-year period in Cairns, Queensland, families of very high socioeconomic status (SES) were 'twice as likely' to have a low acuity presentation to the hospital ED, compared with low SES families. Both Williams et al 14 and Alele et al 15 used the Australian Bureau of Statistics Socio-Economic Indexes for Areas (SEIFA) data and postcode as a means of indicating SES.…”

Section: What This Paper Addsmentioning

confidence: 99%

“…Although Alele et al 15 reported on a large data set collected over a 4-year period in Cairns, Queensland, families of very high socioeconomic status (SES) were 'twice as likely' to have a low acuity presentation to the hospital ED, compared with low SES families. Both Williams et al 14 and Alele et al 15 used the Australian Bureau of Statistics Socio-Economic Indexes for Areas (SEIFA) data and postcode as a means of indicating SES. This is consistent with the international literature where postcode and census data have been used to develop indices that measure a community's level of deprivation.…”

Section: What This Paper Addsmentioning

confidence: 99%

The impact of low socioeconomic status and primary health care access on emergency department presentations in young children in regional Queensland

McCosker

Beccaria

et al. 2023

J Paediatrics Child Health

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AimThe purpose of this study was to empirically evaluate if children from low socio‐economic status (SES) families in regional southeast Queensland utilise acute care services for low acuity health care rather than utilising primary health services.MethodsA retrospective audit of children under the age of 5 years presented at a regional hospital emergency department (ED) over a 12‐month period. Medical records were examined for presenting problem, Australasian triage category, care outcomes, whether the child's parent/guardian held an Australian concession/health care card (AC/HCC) and accessed child health services or a general medical practitioner (GP).ResultsEight hundred and eighty‐eight children who had not reached their fifth birthday presented to ED between 1 June 2019 and 31 May 2020, with a total of 1691 presentations. Most children were bought to the ED by their parents with semi‐urgent health concerns and were discharged home following medical review. Holding an AC/HCC was a significant predictor for hospital presentation. Holding an AC/HCC was not associated with access to child health services. However, accessing child health services resulted in a small but significant increase in hospital presentations.ConclusionsThe AC/HCC may be an important proxy to identify low SES individuals. These card holders tended to use acute services more frequently than those who did not qualify for an AC/HCC. Furthermore, families that engage with primary care services such as child health also accessed acute care services more frequently. The results indicate accessing primary health‐care services does not ameliorate the use of acute care services.

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“…[20][21][22] Other reported factors, such as regular primary care follow-up and parental socioeconomic status, could not be examined in our study. [23][24][25] However, most children have regular paediatric follow-up in Switzerland. 4…”

Section: Comparison With Other Studiesmentioning

confidence: 99%

“…Low-acuity paediatric emergency departments (PEDs) visits are frequent, constituting up to three-quarters of all PED visits. [1][2][3] Unscheduled medical consultations for non-life-threatening issues were traditionally provided by primary care providers in Switzerland. For children, paediatricians are the first-line providers of care with nearly 80% of all preschoolers regularly seeing a primary care paediatrician.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of low-acuity paediatric emergency department consultations in two tertiary hospitals in Switzerland: a retrospective observational study

Jaboyedoff

Starvaggi

Surı́s

et al. 2021

bmjpo

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BackgroundLow-acuity paediatric emergency department (PED) visits are common in high-income countries and are an increasing burden for the healthcare system and quality of care. Little is known about low-acuity PED visits in Switzerland. This study shows frequency and characteristics of such visits in two large PEDs in German-speaking and French-speaking regions of Switzerland.MethodsWe conducted a retrospective observational study in the PED of two Swiss tertiary care hospitals, Bern and Lausanne. We extracted standardised administrative and medical data from the clinic information system for all PED visits of children aged 0–17 years from January to December 2018. We defined low-acuity visits as those meeting all of the following criteria: (1) triage category 4 or 5 on the Australasian Triage Scale, (2) no imaging or laboratory test performed and (3) discharge home. We used a binary multiple logistic regression model to identify factors associated with low-acuity visits.ResultsWe analysed 53 089 PED visits. The proportion of low-acuity visits was 54% (95% CI 53% to 54%, 28 556 visits). Low-acuity visits were associated with age younger than 5 years (adjusted OR, aOR 1.87, 95% CI 1.81 to 1.94), living within a 5 km radius of PED (aOR 1.27, 95% CI 1.22 to 1.32), and after hour presentations (weekends: aOR 1.14, 95% CI 1.10 to 1.18, nights: aOR 1.10, 95% CI 1.23 to 1.36).ConclusionLow-acuity visits are frequent in our PEDs and associated with younger age and convenience factors (proximity of residency and after hour presentation), pointing to a high demand for paediatric urgent care services in Switzerland not currently covered by the primary healthcare system.

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

Cited by 6 publications

References 26 publications

Preventable admissions and emergency-department-visits in pediatric asylum-seeking and non-asylum-seeking patients

Preventable admissions and emergency-department-visits in pediatric asylum-seeking and non-asylum-seeking patients

The impact of low socioeconomic status and primary health care access on emergency department presentations in young children in regional Queensland

Characteristics of low-acuity paediatric emergency department consultations in two tertiary hospitals in Switzerland: a retrospective observational study

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