2.50
Hdl Handle:
http://hdl.handle.net/10755/150202
Type:
Presentation
Title:
Pediatric Utilization of the Emergency Department
Abstract:
Pediatric Utilization of the Emergency Department
Conference Sponsor:Sigma Theta Tau International
Conference Year:2001
Conference Date:November 10 - 14, 2001
Author:MacLean, Susan
P.I. Institution Name:Emergency Nurses Association
Title:Group Director
Objective: In the United States in 1998, over 100,000 million patient visits were made to emergency departments. Of these visits, 22% were children under the 15 years of age and 16% were 15-24 years of age. Recent studies of pediatric utilization of emergency departments and services have included either pediatric patients up to the age of 14 or adolescent patients up to the age of 18 or 21. Few studies have examined children and adolescents’ utilization of emergency departments and services from birth to 21 years of age on a national level. In this dynamic era of health care restructuring, managed care, and the increased need for emergency services, there are obstacles that prevent access to consistent, quality pediatric care. Progress has been made in development of educational programs and models of access to care, but there is need for an accurate profile of pediatric patients who use the emergency department to determine further services for preventative, acute and chronic care. This study was a secondary analysis of two large national multi-center studies of emergency departments visits. The purpose of this study was to describe selected demographic, socioeconomic and other characteristics and behavior illness patterns of the pediatric and adolescent patients who utilized emergency department services in 1996 and 1998. Design: This multi-center study was a descriptive study utilizing ex post facto medical record review. Sample: Pediatric (and adolescent) patients were compared from two randomized studies. The first study described health care utilization of 12,422 emergency department patients, and the second follow-up study described 3,514 frequent users of emergency departments. The total pediatric sample from these two studies was 5,416 patient records. A total of 3,655 pediatric patient records from the first study were compared to 1,761 pediatric patients in the follow-up study of patients who had used the emergency department two or more times within a three-month period. Setting: Medical record reviews were completed in 131 emergency departments in 33 states from the primary studies. Name of Variables or Concepts: pediatric utilization of emergency departments, pediatric illness behavior patterns, acquisition factors of nonurgent, urgent and emergent care, and variable of access to health care of pediatric patients. Measures/Instruments: A Medical Record Data Collection Form was developed for the larger studies of which the secondary samples were derived. The Medical Record Data Collection Form was based on a literature review, the first large study of health care utilization of emergency departments , and the experience of eight nurse researchers. Interrater reliability of 95% was established at the beginning of the larger study. The Medical Record Data Collection Form included demographic, socioeconomic, and information related to the patient’s visit (type of injury, reason for visit and discharge diagnoses). Findings: Both pediatric groups were similar in several demographic categories. Approximately one-third of both pediatric groups were Caucasian, followed by African-American, Hispanic, and others. Most of the patients had primary care providers, were insured, and almost one-half of both groups had Medicaid or MediCal. The majority of patients in both groups came to the emergency department for non-urgent conditions. The most common reason for the visit were: fever, vomiting, cough, abdominal pain or cramping, earache, and accidents. The most frequent diagnoses for the two groups were: otitis media, acute respiratory infections, asthma, viral infection, acute pharyngitis, and noninfectious gastroenteritis. The two most common reasons for emergency visits by the pediatric group of repeat patients was “their condition was too serious to go elsewhere” (37%), and their “usual health care provider wasn’t available” (29.7%). Conclusions: The results raise concern of the large number of pediatric and adolescent patients who used the emergency departments for nonurgent conditions. Many of the pediatric patients from the second primary study were repeat patients who had two or three visits within a few months for chronic conditions of asthma or acute respiratory symptoms. Implications: This study has implications for health care providers to improve strategies to help parents manage acute and chronic pediatric problems. Further research is needed on patients’ and their parents’ interpretation of the seriousness of symptoms that warrant urgent vs. nonurgent care as well as examination of other factors involved in after hours access to care.
Repository Posting Date:
26-Oct-2011
Date of Publication:
10-Nov-2001
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titlePediatric Utilization of the Emergency Departmenten_GB
dc.identifier.urihttp://hdl.handle.net/10755/150202-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Pediatric Utilization of the Emergency Department</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2001</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">November 10 - 14, 2001</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">MacLean, Susan</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Group Director</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">smaclean@ena.org</td></tr><tr><td colspan="2" class="item-abstract">Objective: In the United States in 1998, over 100,000 million patient visits were made to emergency departments. Of these visits, 22% were children under the 15 years of age and 16% were 15-24 years of age. Recent studies of pediatric utilization of emergency departments and services have included either pediatric patients up to the age of 14 or adolescent patients up to the age of 18 or 21. Few studies have examined children and adolescents&rsquo; utilization of emergency departments and services from birth to 21 years of age on a national level. In this dynamic era of health care restructuring, managed care, and the increased need for emergency services, there are obstacles that prevent access to consistent, quality pediatric care. Progress has been made in development of educational programs and models of access to care, but there is need for an accurate profile of pediatric patients who use the emergency department to determine further services for preventative, acute and chronic care. This study was a secondary analysis of two large national multi-center studies of emergency departments visits. The purpose of this study was to describe selected demographic, socioeconomic and other characteristics and behavior illness patterns of the pediatric and adolescent patients who utilized emergency department services in 1996 and 1998. Design: This multi-center study was a descriptive study utilizing ex post facto medical record review. Sample: Pediatric (and adolescent) patients were compared from two randomized studies. The first study described health care utilization of 12,422 emergency department patients, and the second follow-up study described 3,514 frequent users of emergency departments. The total pediatric sample from these two studies was 5,416 patient records. A total of 3,655 pediatric patient records from the first study were compared to 1,761 pediatric patients in the follow-up study of patients who had used the emergency department two or more times within a three-month period. Setting: Medical record reviews were completed in 131 emergency departments in 33 states from the primary studies. Name of Variables or Concepts: pediatric utilization of emergency departments, pediatric illness behavior patterns, acquisition factors of nonurgent, urgent and emergent care, and variable of access to health care of pediatric patients. Measures/Instruments: A Medical Record Data Collection Form was developed for the larger studies of which the secondary samples were derived. The Medical Record Data Collection Form was based on a literature review, the first large study of health care utilization of emergency departments , and the experience of eight nurse researchers. Interrater reliability of 95% was established at the beginning of the larger study. The Medical Record Data Collection Form included demographic, socioeconomic, and information related to the patient&rsquo;s visit (type of injury, reason for visit and discharge diagnoses). Findings: Both pediatric groups were similar in several demographic categories. Approximately one-third of both pediatric groups were Caucasian, followed by African-American, Hispanic, and others. Most of the patients had primary care providers, were insured, and almost one-half of both groups had Medicaid or MediCal. The majority of patients in both groups came to the emergency department for non-urgent conditions. The most common reason for the visit were: fever, vomiting, cough, abdominal pain or cramping, earache, and accidents. The most frequent diagnoses for the two groups were: otitis media, acute respiratory infections, asthma, viral infection, acute pharyngitis, and noninfectious gastroenteritis. The two most common reasons for emergency visits by the pediatric group of repeat patients was &ldquo;their condition was too serious to go elsewhere&rdquo; (37%), and their &ldquo;usual health care provider wasn&rsquo;t available&rdquo; (29.7%). Conclusions: The results raise concern of the large number of pediatric and adolescent patients who used the emergency departments for nonurgent conditions. Many of the pediatric patients from the second primary study were repeat patients who had two or three visits within a few months for chronic conditions of asthma or acute respiratory symptoms. Implications: This study has implications for health care providers to improve strategies to help parents manage acute and chronic pediatric problems. Further research is needed on patients&rsquo; and their parents&rsquo; interpretation of the seriousness of symptoms that warrant urgent vs. nonurgent care as well as examination of other factors involved in after hours access to care.</td></tr></table>en_GB
dc.date.available2011-10-26T10:18:50Z-
dc.date.issued2001-11-10en_GB
dc.date.accessioned2011-10-26T10:18:50Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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