Urban Emergency Department Utilization by Adolescents

Abstract

This study describes urban emergency department (ED) utilization and follow-up referral patterns among adolescents. ED visits for 14-19-year-old patients at an urban university hospital with adjacent adult and pediatric emergency departments during specified months in 1993 were retrospectively reviewed. A subgroup (n=150) was randomly selected for detailed chart review. One thousand six hundred and thirty-six adolescents were seen in the ED during the study period. Public assistance (n=763; 47%) and commercial insurance (n=480; 29%) were the most common forms of insurance, followed by self-pay (n=357; 22%). The majority of triage codes for ED visits were nonurgent (n=140; 93%). Twenty-five patients (17%) were not referred for follow-up upon ED discharge. Adolescents on public assistance or without insurance may frequently utilize an urban ED for nonurgent medical problems. A group of patients did not identify a primary care provider at triage and were not referred for follow-up. Defining medical problems for which adolescents utilize the ED may help health professionals to tailor community resources to better serve adolescent health care needs.

Characteristics That Distinguish Adolescents Who Present to a Children's Hospital Emergency Department From Those Presenting to a General Emergency Department

“…This difference may reflect patient preference for separating from a children's hospital with increasing age. Although female adolescents used both EDs more often than males, similar to prior reports, 8,9 the proportion of female patients seen at the general ED was larger than that at the children's hospital. This could be due to different expectations of particular services, such as gynecologic care.…”

Characteristics of Youth Seeking Emergency Care for Assault Injuries

“…18,64 In multivariate analysis, the assault-injured youth were less likely to be in school, so they will not have access to schoolbased violence prevention. 65,66 Previous work 14,[67][68][69] also indicates that these highrisk youth, particularly boys, are unlikely to have any other source of medical care.…”

Examining the Role of the Pediatric Emergency Department in Reducing Unintended Adolescent Pregnancy

“…4 Low uptake of contraceptive use may, in part, be explained by limited use of preventive care services by adolescents. More than one-third of adolescents report no source of primary care 5–8 and less than one-third have received contraceptive counseling. 9 …”