Making choices: why parents present to the emergency department for non-urgent care

Abstract

Objectives: This study aims to provide a better understanding of the motivations and actions of parents of children with non-urgent injury or illness who attend the emergency department at a tertiary paediatric hospital seeking care. Design: A prospective questionnaire-based survey of 355 parents aimed to ascertain information about parent caregiving and care-seeking behaviours prior to presentation at the emergency department with their child. Results: A total of 355 parents were surveyed, representing 8% of the parents/carers presenting to the emergency department in a 3-month period for nonurgent (Australasian Triage System 4 and 5) care of their child. The factors identified were: parents rated their child's condition as moderate to very serious (242 (68%)); two-thirds of parents (234 (66%)) had sought advice prior to attending the emergency department; 54% (77) of the 137 children who attended with an injury presented promptly to emergency (ie, within 4 h of injury) whereas of the 216 presenting with an illness, 41% (88) presented within 2-7 days of the onset of the illness. Conclusions: This study displayed the accuracy of ''parental triage,'' that is, parents assess their child's health and generally engage in appropriate care-giving and care-seeking behaviours before presenting to a paediatric emergency department. Highlighted are the deficiencies in current primary care services available to families and the perception that not all cases deemed as non-urgent by the emergency department are able to be dealt with in a primary care setting.

Understanding decisions leading to nonurgent visits to the paediatric emergency department: caregivers’ perspectives

“…The results of our study confirm previous findings that caregivers are heavily influenced by the perceived severity of the disease in the child when deciding on where to go for medical care. (9)(10)(11)(12)(13) Most of the caregivers in our study had a regular source of care for their child and attended the ED for problems perceived as serious. Even though those visits were classified as nonurgent by clinicians, the caregivers may have engaged in 'appropriate' behaviour based on their existing knowledge.…”

“…Even though those visits were classified as nonurgent by clinicians, the caregivers may have engaged in 'appropriate' behaviour based on their existing knowledge. (13,23) Thus, it is essential to improve the knowledge of caregivers on child health matters; this will help to optimise the caregivers' navigation of the healthcare system. (24) Caregivers also attended paediatric EDs due to their need for assurance and the perceived advantage of paediatric EDs over primary care providers.…”

“…Previous studies on caregivers' perspectives revealed perceived need as a common reason; this perceived need is related to the perceived severity of the child's illness, (7,(9)(10)(11)(12)(13) the need to seek assurance on the course of the illness (7) and the expectation that medical tests, such as radiography, will be needed. (7,10,13) Caregivers' perceptions of primary healthcare providers are also a key contributing factor to the nonurgent use of paediatric EDs.…”

“…Previous studies on caregivers' perspectives revealed perceived need as a common reason; this perceived need is related to the perceived severity of the child's illness, (7,(9)(10)(11)(12)(13) the need to seek assurance on the course of the illness (7) and the expectation that medical tests, such as radiography, will be needed. (7,10,13) Caregivers' perceptions of primary healthcare providers are also a key contributing factor to the nonurgent use of paediatric EDs. Several studies indicated that caregiver dissatisfaction with primary healthcare providers was due to accessibility and scheduling issues, (9)(10)(11) as well as the perception that the quality of care given by primary healthcare providers is lower than that given at the ED.…”

Estudio piloto de consulta telefónica pediátrica

“…La mayoría de las pato logías que motivan estas visitas al especialista son de características banales, y muchas veces sirven para tranquilizar a los padres más que para sanar al hijo 1 . Se plantean muchos interrogantes a nivel de la gestión de la salud en torno a qué medidas serían más eficaces para reducir el uso masivo de estos servicios y para establecer unos sistemas de selección que determinen la prioridad de la urgencia.…”