Pediatric Primary Care Relationships and Non-Urgent Emergency Department Use in Children

Kirby, Shannon; Wooten, William; Spanier, Adam J.

doi:10.1016/j.acap.2021.03.019

Cited by 9 publications

(5 citation statements)

References 26 publications

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“…In addition, lack of knowledge about viable alternatives and limited information about outpatient clinicians' resources may further predispose nonemergent ED presentations. 4,25,53,54 We also observed a small increase in ED visits related to mental health and substance use disorders across both expansion and nonexpansion states. 23 Our data fall within the years of the second wave of the opioid epidemic in the US, when ED visits for substance use disorders increased by more than 30%.…”

Section: Jama Network Open | Health Policymentioning

confidence: 73%

“…In addition, lack of knowledge about viable alternatives and limited information about outpatient clinicians’ resources may further predispose nonemergent ED presentations. 4 , 25 , 53 , 54…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, many individuals are not equipped to accurately perceive the severity of their condition and might overestimate the need for emergency care, particularly after regular office hours or when outpatient care is not available. In addition, lack of knowledge about viable alternatives and limited information about outpatient clinicians’ resources may further predispose nonemergent ED presentations …”

Section: Discussionmentioning

confidence: 99%

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Association of Medicaid Expansion With Emergency Department Visits by Medical Urgency

2022

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Key Points Question Is Medicaid eligibility expansion associated with changes in emergency department (ED) visits based on the medical urgency of the conditions? Findings In this cross-sectional study of 80.6 million ED visits across 4 US states, ED visits per 1000 population decreased for states that expanded Medicaid compared with states that did not. This decrease was associated with decreases in ED visits for less-emergent or nonemergent conditions. Meaning The findings of this study suggest that expanding Medicaid might reduce ED visits for conditions that could be treated in outpatient settings.

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Section: Jama Network Open | Health Policymentioning

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Association of Medicaid Expansion With Emergency Department Visits by Medical Urgency

2022

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“…Moreover, studies also focused on ED frequent visitors and related factors [ 16 – 19 ]. Besides, other studies and reviews reported the reasons for inappropriately use of ED including the role of primary care before visit, less frequently studied [ 19 – 21 ].…”

Section: Introductionmentioning

confidence: 99%

One-year emergency department visits for children < 18 years of age, associated factors and frequency of primary general practitioner or pediatrician visits before: a French observational study (2018–19)

Pergeline,

Lesuffleur,

Fresson

et al. 2024

BMC Prim. Care

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Background This study was designed to identify factors associated with at least one emergency department (ED) visit and those associated without consultation by a general practitioner or paediatrician (GPP) before ED visit. Levels of annual consumption of healthcare services as a function of the number of ED visit were reported. Methods This retrospective study focused on children < 18 years of age living in mainland France and followed for one-year after their birth or birthday in 2018. Children were selected from the national health data system, which includes data on healthcare reimbursements, long-term chronic diseases (LTD) eligible for 100% reimbursement, and individual complementary universal insurance (CMUc) status granted to households with a low annual income. Adjusted odds ratios (OR) were estimated using multivariate logistic regression. Results There were 13.211 million children included (94.2% of children; girls 48.8%). At least one annual ED visit was found for 24% (1: 16%, 2: 5%, 3 or more: 3%) and 14% of visits led to hospitalization. Factors significantly associated with at least one ED visit were being a girl (47.1%; OR = 0.92), age < 1 year (9.1%; OR = 2.85), CMUc (22.7%, OR = 1.45), an ED in the commune of residence (33.3%, OR = 1.15), type 1 diabetes (0.25%; OR = 2.4), epilepsy (0.28%; OR = 2.1), and asthma (0.39%; OR = 2.0). At least one annual short stay hospitalisation (SSH) was found for 8.8% children of which 3.4% after an ED visit. A GPP visit the three days before or the day of the ED visit was found for 19% of children (< 1 year: 29%, 14–17 years: 13%). It was 30% when the ED was followed by SSH and 17% when not. Significant factors associated with the absence of a GPP visit were being a girl (OR = 0.9), age (1 year OR = 1.4, 14–17 years OR = 3.5), presence of an ED in the commune of residence (OR = 1.12), epilepsy LTD (OR = 1.1). Conclusion The low level of visits to GPP prior to a visit to the ED and the associated factors are the elements to be taken into account for appropriate policies to limit ED overcrowding. The same applies to factors associated with a visit to the ED, in order to limit daily variations.

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“…Na faixa etária pediátrica, a febre constitui uma das principais causas de idas ao Serviço de Urgência Pediátrica (SUP) (Leigh et al, 2020). A menor idade da criança foi associada ao aumento das idas não urgentes ao SUP, conduzindo a custos extraordinários de saúde e, consequentemente, impacto na qualidade dos cuidados aí prestados (Kirby et al, 2021). Regra geral, no domínio das situações não urgentes, o que se verifica é uma falta de entendimento, por parte dos pais/cuidadores, sobre os conhecimentos básicos (Edwars et al, 2020).…”

Section: Introductionunclassified

Capacitação parental no lactente com febre. Enfermeiro especialista em saúde infantil e pediátrica: revisão integrativa

Abreu,

Barcelos,

Fernandes

2024

JIM

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A febre é um motivo de grande preocupação e os pais/cuidadores, de forma excessiva, recorrem aos recursos disponíveis, saturando-os.Objetivo: Identificar as intervenções educativas, desenvolvidas pelo Enfermeiro Especialista em Saúde Infantil e Pediátrica (EESIP), descritas na literatura, nos Cuidados de Saúde Primários (CSP) e hospitalares, na capacitação parental ao cuidar do lactente com febre.Metodologia: Revisão Integrativa em bases de dados científicas. Recorreu-se à estratégia PICo, delineando-se a questão de investigação: "Quais as intervenções educativas, descritas na literatura, nos CSP e hospitalares, do EESIP, na capacitação parental ao cuidar do lactente com febre?".Resultados: Amostra final constituída por cinco artigos. Intervenções educativas categorizadas em formato papel, digital ou comunicação verbal direta, no contexto dos CSP e Hospitalares.Conclusão: Diversas foram as intervenções enumeradas com repercussões positivas na capacitação de pais e cuidadores de lactentes com febre. Tais repercussões surtem impacto na afluência aos serviços de saúde, custos associados, melhoria da qualidade dos cuidados, aumento da satisfação de famílias e profissionais, bem como redução da ansiedade parental.

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Pediatric Primary Care Relationships and Non-Urgent Emergency Department Use in Children

Cited by 9 publications

References 26 publications

Association of Medicaid Expansion With Emergency Department Visits by Medical Urgency

Association of Medicaid Expansion With Emergency Department Visits by Medical Urgency

One-year emergency department visits for children < 18 years of age, associated factors and frequency of primary general practitioner or pediatrician visits before: a French observational study (2018–19)

Capacitação parental no lactente com febre. Enfermeiro especialista em saúde infantil e pediátrica: revisão integrativa

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