Determinants of nonurgent use of the emergency department for pediatric patients in 12 hospitals in Belgium
Introduction The nonurgent use of the emergency department (ED) for pediatric patients is an increasing problem facing healthcare systems worldwide. To evaluate the magnitude of the phenomenon and to identify associated factors, an observational prospective survey was performed including all patient...
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| Veröffentlicht in: | European journal of pediatrics 2012-12, Vol.171 (12), p.1829-1837 |
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| container_title | European journal of pediatrics |
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| creator | Benahmed, N. Laokri, S. Zhang, W. H. Verhaeghe, N. Trybou, J. Cohen, L. De Wever, A. Alexander, S. |
| description | Introduction
The nonurgent use of the emergency department (ED) for pediatric patients is an increasing problem facing healthcare systems worldwide. To evaluate the magnitude of the phenomenon and to identify associated factors, an observational prospective survey was performed including all patients ( |
| doi_str_mv | 10.1007/s00431-012-1853-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1220792437</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1220792437</sourcerecordid><originalsourceid>FETCH-LOGICAL-c402t-a032f117dd6931e24f3c4e629f991025e8f68d29baef9c5b50ad13c977624c773</originalsourceid><addsrcrecordid>eNp1kU1v1DAQhi1ERZfCD-CCIiEkLike22vHR1q-KlXiAmfL64y3LokTbOew_x6HXT6E1JM1M8_MvJ6XkBdAL4FS9TZTKji0FFgL3Za3h0dkA4LXiCr5mGwoF7SVoPU5eZrzPa09Gron5JxxKoUSYkO-v8eCaQzRxpKbyTdxikvaYyzNknFNlDtscMQ15w5Nj7NNZVzrfkrNjH2wJQXXzLYEXGeE2ABr7qY8h2KHX_EVDvuwjM_Ima8ZfH56L8i3jx--Xn9ub798url-d9s6QVlpLeXMA6i-l5oDMuG5EyiZ9loDZVvsvOx6pncWvXbb3ZbaHrjTSkkmnFL8grw5zp3T9GPBXMwYssNhsBGnJRtgrB6CCb6ir_5D76clxaquUlLyTnQCKgVHyqUp54TezCmMNh0MULM6YY5OmOqEWZ0wh9rz8jR52Y3Y_-n4ffoKvD4BNjs7-GSjC_kvJ6WqX1olsiOXaynuMf0j8cHtPwHsOKCx</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1266384841</pqid></control><display><type>article</type><title>Determinants of nonurgent use of the emergency department for pediatric patients in 12 hospitals in Belgium</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Benahmed, N. ; Laokri, S. ; Zhang, W. H. ; Verhaeghe, N. ; Trybou, J. ; Cohen, L. ; De Wever, A. ; Alexander, S.</creator><creatorcontrib>Benahmed, N. ; Laokri, S. ; Zhang, W. H. ; Verhaeghe, N. ; Trybou, J. ; Cohen, L. ; De Wever, A. ; Alexander, S.</creatorcontrib><description>Introduction
The nonurgent use of the emergency department (ED) for pediatric patients is an increasing problem facing healthcare systems worldwide. To evaluate the magnitude of the phenomenon and to identify associated factors, an observational prospective survey was performed including all patients (<15 years) attending the ED in 12 Belgian hospitals during 2 weeks in autumn 2010. Use of ED was considered appropriate if at least one of the following criteria was met: child referred by doctor or police, brought by ambulance, in need for short stay, technical examination or orthopedic treatment, in-patient admission, or death. Among the 3,117 children, attending ED, 39.9 % (1,244) of visits were considered inappropriate. Five factors were significantly associated with inappropriate use: age of child, distance to ED, having a registered family doctor, out-of-hours visit, and geographic region. The adjusted odds ratio and 95 % confidence intervals are respectively—1.7 (1.3–2.0), 1.7 (1.3–2.2), 1.5 (1.1–2.2), 1.5 (1.2–1.9), and 0.6 (0.5–0.8).
Conclusions
Almost 40 % of all paediatric ED attendances did not require hospital expertise. The risk of an inappropriate use of ED by pediatrician patients is predominantly associated with organizational and cultural factors. Access, equity, quality of care, and medical human resources availability have to be taken into account to design financially sustainable model of care for those patients. Furthermore, future research is needed to explain reasons why parents visit ED rather than using of primary-care services.</description><identifier>ISSN: 0340-6199</identifier><identifier>EISSN: 1432-1076</identifier><identifier>DOI: 10.1007/s00431-012-1853-y</identifier><identifier>PMID: 23064744</identifier><identifier>CODEN: EJPEDT</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Belgium ; Biological and medical sciences ; Child ; Child, Preschool ; Confidence Intervals ; Emergency medical care ; Emergency Service, Hospital - utilization ; Female ; General aspects ; Health Services Misuse - statistics & numerical data ; Health Services Needs and Demand - utilization ; Hospitals ; Hospitals, Pediatric ; Humans ; Infant ; Length of Stay ; Male ; Medical sciences ; Medicine ; Medicine & Public Health ; Miscellaneous ; Odds Ratio ; Original Paper ; Parents & parenting ; Parents - psychology ; Patient Admission - statistics & numerical data ; Patient Satisfaction ; Patients ; Pediatrics ; Physician-Patient Relations ; Primary Health Care - utilization ; Prospective Studies ; Public health ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Questionnaires ; Referral and Consultation ; Response rates ; Workloads</subject><ispartof>European journal of pediatrics, 2012-12, Vol.171 (12), p.1829-1837</ispartof><rights>Springer-Verlag Berlin Heidelberg 2012</rights><rights>2014 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c402t-a032f117dd6931e24f3c4e629f991025e8f68d29baef9c5b50ad13c977624c773</citedby><cites>FETCH-LOGICAL-c402t-a032f117dd6931e24f3c4e629f991025e8f68d29baef9c5b50ad13c977624c773</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00431-012-1853-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00431-012-1853-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51298</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26679777$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23064744$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Benahmed, N.</creatorcontrib><creatorcontrib>Laokri, S.</creatorcontrib><creatorcontrib>Zhang, W. H.</creatorcontrib><creatorcontrib>Verhaeghe, N.</creatorcontrib><creatorcontrib>Trybou, J.</creatorcontrib><creatorcontrib>Cohen, L.</creatorcontrib><creatorcontrib>De Wever, A.</creatorcontrib><creatorcontrib>Alexander, S.</creatorcontrib><title>Determinants of nonurgent use of the emergency department for pediatric patients in 12 hospitals in Belgium</title><title>European journal of pediatrics</title><addtitle>Eur J Pediatr</addtitle><addtitle>Eur J Pediatr</addtitle><description>Introduction
The nonurgent use of the emergency department (ED) for pediatric patients is an increasing problem facing healthcare systems worldwide. To evaluate the magnitude of the phenomenon and to identify associated factors, an observational prospective survey was performed including all patients (<15 years) attending the ED in 12 Belgian hospitals during 2 weeks in autumn 2010. Use of ED was considered appropriate if at least one of the following criteria was met: child referred by doctor or police, brought by ambulance, in need for short stay, technical examination or orthopedic treatment, in-patient admission, or death. Among the 3,117 children, attending ED, 39.9 % (1,244) of visits were considered inappropriate. Five factors were significantly associated with inappropriate use: age of child, distance to ED, having a registered family doctor, out-of-hours visit, and geographic region. The adjusted odds ratio and 95 % confidence intervals are respectively—1.7 (1.3–2.0), 1.7 (1.3–2.2), 1.5 (1.1–2.2), 1.5 (1.2–1.9), and 0.6 (0.5–0.8).
Conclusions
Almost 40 % of all paediatric ED attendances did not require hospital expertise. The risk of an inappropriate use of ED by pediatrician patients is predominantly associated with organizational and cultural factors. Access, equity, quality of care, and medical human resources availability have to be taken into account to design financially sustainable model of care for those patients. Furthermore, future research is needed to explain reasons why parents visit ED rather than using of primary-care services.</description><subject>Belgium</subject><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Confidence Intervals</subject><subject>Emergency medical care</subject><subject>Emergency Service, Hospital - utilization</subject><subject>Female</subject><subject>General aspects</subject><subject>Health Services Misuse - statistics & numerical data</subject><subject>Health Services Needs and Demand - utilization</subject><subject>Hospitals</subject><subject>Hospitals, Pediatric</subject><subject>Humans</subject><subject>Infant</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Miscellaneous</subject><subject>Odds Ratio</subject><subject>Original Paper</subject><subject>Parents & parenting</subject><subject>Parents - psychology</subject><subject>Patient Admission - statistics & numerical data</subject><subject>Patient Satisfaction</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Physician-Patient Relations</subject><subject>Primary Health Care - utilization</subject><subject>Prospective Studies</subject><subject>Public health</subject><subject>Public health. Hygiene</subject><subject>Public health. 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H.</au><au>Verhaeghe, N.</au><au>Trybou, J.</au><au>Cohen, L.</au><au>De Wever, A.</au><au>Alexander, S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Determinants of nonurgent use of the emergency department for pediatric patients in 12 hospitals in Belgium</atitle><jtitle>European journal of pediatrics</jtitle><stitle>Eur J Pediatr</stitle><addtitle>Eur J Pediatr</addtitle><date>2012-12-01</date><risdate>2012</risdate><volume>171</volume><issue>12</issue><spage>1829</spage><epage>1837</epage><pages>1829-1837</pages><issn>0340-6199</issn><eissn>1432-1076</eissn><coden>EJPEDT</coden><abstract>Introduction
The nonurgent use of the emergency department (ED) for pediatric patients is an increasing problem facing healthcare systems worldwide. To evaluate the magnitude of the phenomenon and to identify associated factors, an observational prospective survey was performed including all patients (<15 years) attending the ED in 12 Belgian hospitals during 2 weeks in autumn 2010. Use of ED was considered appropriate if at least one of the following criteria was met: child referred by doctor or police, brought by ambulance, in need for short stay, technical examination or orthopedic treatment, in-patient admission, or death. Among the 3,117 children, attending ED, 39.9 % (1,244) of visits were considered inappropriate. Five factors were significantly associated with inappropriate use: age of child, distance to ED, having a registered family doctor, out-of-hours visit, and geographic region. The adjusted odds ratio and 95 % confidence intervals are respectively—1.7 (1.3–2.0), 1.7 (1.3–2.2), 1.5 (1.1–2.2), 1.5 (1.2–1.9), and 0.6 (0.5–0.8).
Conclusions
Almost 40 % of all paediatric ED attendances did not require hospital expertise. The risk of an inappropriate use of ED by pediatrician patients is predominantly associated with organizational and cultural factors. Access, equity, quality of care, and medical human resources availability have to be taken into account to design financially sustainable model of care for those patients. Furthermore, future research is needed to explain reasons why parents visit ED rather than using of primary-care services.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>23064744</pmid><doi>10.1007/s00431-012-1853-y</doi><tpages>9</tpages></addata></record> |
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| subjects | Belgium Biological and medical sciences Child Child, Preschool Confidence Intervals Emergency medical care Emergency Service, Hospital - utilization Female General aspects Health Services Misuse - statistics & numerical data Health Services Needs and Demand - utilization Hospitals Hospitals, Pediatric Humans Infant Length of Stay Male Medical sciences Medicine Medicine & Public Health Miscellaneous Odds Ratio Original Paper Parents & parenting Parents - psychology Patient Admission - statistics & numerical data Patient Satisfaction Patients Pediatrics Physician-Patient Relations Primary Health Care - utilization Prospective Studies Public health Public health. Hygiene Public health. Hygiene-occupational medicine Questionnaires Referral and Consultation Response rates Workloads |
| title | Determinants of nonurgent use of the emergency department for pediatric patients in 12 hospitals in Belgium |
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