Parents appear to be using ED for non-emergency medical situations

Sands R. Emerg Med J. 2011;doi:10.1136/emj.2010.106229.

The number of pediatric patients visiting an ED increased more than 40% during a recent 10-year period, according to study results.

The retrospective review of electronic patient records involved data from children presenting at a pediatric ED in the United Kingdom. A cohort of 39,394 children aged 0 to 15 years who visited the ED between Feb. 7, 2007, and Feb. 6, 2008, was compared with a cohort of 38,982 children from a period 10 years earlier.

The researchers collected data on presenting problem and source of referral, besides demographic information. The presenting problems were ranked and compared with data from the previous cohort.

There were 14,724 medical-related visits in the recent cohort and 10,369 medical-related visits in the 1997 cohort. This was an increase of 42%, according to the results.

The 10 most common presenting problems accounted for 85% of ED visits. The most frequently observed problems included:

Breathing difficulty, 20.1%.
Febrile illness, 14.1%.
Diarrhea with or without vomiting, 14%.
Rash, 8.6%.
Cough, 6.7%.

Similar proportions of presenting problems were observed in the 1997 cohort. The researchers said, however, fewer patients visited the ED with breathing problems 10 years previously (–10.9%; P<.001).

“These results suggest the increasing utilization of ED services for children with common medical presenting problems,” the researchers wrote. The results “should inform further research exploring the pathways for attendance and the thresholds in seeking medical advice in order to inform the commissioning of pediatric emergency and urgent care services.”

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