Understanding the characteristics of recurrent visits to the emergency department by paediatric patients: a retrospective observational study conducted at three tertiary hospitals in Korea

Abstract

ObjectivesThe number of paediatric patients visiting the emergency department (ED) continues to rise. In South Korea, approximately 25% of the patients who visit the ED are paediatric patients. In the USA, about 20% of the paediatric population were found to have visited the ED in the past year. A recent study demonstrated that 4.5%–8% of patients account for 25% of all ED visits. Therefore, the aim of this study was to identify the characteristics of recurrent visits.MethodsDesign: retrospective observational study. Setting: this study examined and analysed medical record data involving three tertiary EDs. Participants: a total of 46 237 ED visits by patients <16 years during 1-year period. Main outcome measures: data collected included the number of recurrent ED patients, frequency of recurrent visits, age, sex, insurance status, period until recurrent visit (days), main diagnosis and ED discharge results.ResultsExcluding patients with multiple visits, the total number of paediatric patients who fit the study criteria was 33 765. Among these patients, 23 384 (69.2%) had no recurrent ED visits in the subsequent year after their first visit. A total of 15 849 (46.8%) patients were toddlers (between age 1 and 4 years). In the patient group without a recurrent visit, fever was the most common diagnosis.ConclusionsOur study reviewed medical records to inspect the characteristics of patients who return to care. Higher recurrent visit frequency was associated with using the 119 rescue centre service, having a medical condition, with younger age and a higher rate of hospitalisation. Analysis of the factors associated with frequent ED visits will help to improve care for paediatric patients who visit the ED.

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

“…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]. In a study from the UK, no association between non-urgent presentations and the asylum-status was found [38].…”

“…It may also result in increased numbers of presentations with non-urgent conditions at emergency departments. There is a global trend of an increase in non-urgent visits at emergency departments in high-income countries, which could also potentially be prevented by primary health care [18][19][20][21]. Asylum-seeking children are at risk of lacking integration into the primary health care system and may therefore have higher rates of ambulatory-care-sensitive admissions and non-urgent emergency-department presentations than their local peers.…”

Health care provided to recent asylum-seeking and non-asylum-seeking pediatric patients at a Swiss tertiary hospital

“…A similar age distribution in pediatric emergency department visits was seen in other parts of the world. A Californian and a Korean study both showed frequent visits to emergency departments were more common in children aged 1 to 4 years [31,32]. However, these studies did not detail if asylum-seeking children were included.…”

Health care provided to asylum-seeking and non-asylum-seeking paediatric patients at a Swiss tertiary hospital

“…A similar age distribution in paediatric emergency department visits was seen in other parts of the world. A Californian and a Korean study both showed frequent visits to emergency departments were more common in children aged 1 to 4 years (29,30). However, these studies did not detail if asylum-seeking children were included.…”