Understanding Pediatric Caretakers’ Views on Obtaining Medical Care for Low‐acuity Illness

Cabey, Whitney; Shea, Judy A.; Kangovi, Shreya; Kennedy, Danielle; Onwuzulike, Chiamaka; Fein, Joel A.

doi:10.1111/acem.13436

Cited by 5 publications

(6 citation statements)

References 30 publications

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“…In a study exploring care seeking in lone parents in the UK with a partner on active duty abroad, a lack of support at home increased the likelihood that they would seek care when their child was unwell [ 32 ]. This latter finding is analogous to other studies which found that being a single-parent was a risk factor for higher ED use for non-urgent conditions [ 61 , 76 ], such that parents with limited social support were more frequent ED attenders [ 37 ] and living in low income areas made the ED a more convenient choice for stressed families [ 38 ].…”

Section: Resultssupporting

confidence: 86%

“… 68% public insurance, 18% private insurance Not reported Bingham et al, 2015 [ 34 ] 1531 Not reported Parent/caregiver Not reported Not reported Not reported Buboltz et al, 2015 [ 35 ] 12 Not reported; 100% Female Mothers (1 grandmother) Not reported Considered part of a vulnerable population Not reported Burokienė et al, 2017 [ 36 ] 381 < 35 yrs. (69.5%) Gender not reported Parent/caregiver Not reported 65% held a university degree Non-urgent Cabey et al, 2018 [ 37 ] 57 Mean: 33 yrs. ; Gender not reported Parent/caregiver Mean: 6.5 years 56.1% employed; 28.1% private insurance Not reported Chin et al, 2006 [ 38 ] 12 Not reported Parent/caregiver Not reported All were from zip codes known to represent low- income areas.…”

Section: Resultsmentioning

confidence: 99%

“…Older parents were 2.07 (95% CI, 1.1224–3.506) times more likely to evaluate their child’s health unfavourably than younger parents. Cabey et al, 2018 [ 37 ] USA Explore caretaker decision making processes, values, and priorities when deciding to seek care. Qualitative; Interviews; Grounded theory Purposively sampled patients with high or low frequency ED and primary care use for low-acuity visits.…”

Section: Resultsmentioning

confidence: 99%

“…The need for reassurance featured heavily as a common reason parents seek healthcare at the ED. Specifically, parents wanted reassurance that their child’s illness is not serious or will not become more urgent, while also seeking guidance on how to manage the condition [ 25 , 37 , 41 , 56 , 60 , 82 ]. Reassurance and seeking guidance on how to manage specific conditions such as respiratory tract infections (RTI) [ 49 , 71 ] and for general illnesses [ 66 ] also factored into the decision of parents choosing to attend their GP.…”

Section: Resultsmentioning

confidence: 99%

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Factors that influence family and parental preferences and decision making for unscheduled paediatric healthcare – systematic review

Nicholson

McDonnell

Brún

et al. 2020

BMC Health Serv Res

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Introduction Health systems offer access to unscheduled care through numerous routes; however, it is typically provided by general practitioners (GPs), by emergency medicine doctors in in emergency departments (EDs) and by GPs in out-of-hours GP services such as practitioner cooperatives. Unscheduled healthcare constitutes a substantial portion of healthcare delivery. A systematic review was conducted to establish the factors that influence parents’ decision making when seeking unscheduled healthcare for their children. The systematic review question was “ What are the factors that influence the decision making of parents and families seeking unscheduled paediatric healthcare?” Method Five databases (CINAHL, PubMed, SCOPUS, PsycInfo, EconLit) and four grey literature databases (Proquest, Lenus, OpenGrey, Google Scholar) were searched. The titles and abstracts of 3746 articles were screened and full-text screening was performed on 177 of these articles. Fifty-six papers were selected for inclusion in the review. Data relating to different types of unscheduled health services (namely primary care, the emergency department and out-of-hours services) were extracted from these articles. A narrative approach was used to synthesise the extracted data. Results Several factors were identified as influencing parental preferences and decision making when seeking unscheduled healthcare for their children. A number of the included studies identified pre-disposing factors such as race, ethnicity and socioeconomic status (SES) as impacting the healthcare-seeking behaviour of parents. Unscheduled healthcare use was often initiated by the parent’s perception that the child’s condition was urgent and their need for reassurance. The choice of unscheduled service was influenced by a myriad of factors such as: waiting times, availability of GP appointments, location of the ED, and the relationship that the parent or caregiver had with their GP. Conclusion Policy and planning initiatives do not always reflect how patients negotiate the health system as a single entity with numerous entry points. Altering patients’ behaviour through public health initiatives that seek to improve, for instance, health literacy or reducing emergency hospital admissions through preventative primary care requires an understanding of the relative importance of factors that influence behaviour and decision making, and the interactions between these factors.

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Section: Resultssupporting

confidence: 86%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Factors that influence family and parental preferences and decision making for unscheduled paediatric healthcare – systematic review

Nicholson

McDonnell

Brún

et al. 2020

BMC Health Serv Res

View full text Add to dashboard Cite

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“…Parents with low levels of social support are often higher users of the ED for lower acuity conditions (Cabey et al . 2018). Single parent families (Zandieh et al .…”

Section: Introductionmentioning

confidence: 99%

Healthcare utilisation and unmet health needs in children with intellectual disability: a propensity score matching approach using longitudinal cohort data

Nicholson

Doherty

Guérin

et al. 2022

J intellect Disabil Res

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Background Health disparities for children with intellectual disabilities can be challenging to measure due to many other factors that can impact health and healthcare use. The aim of the current study was to use longitudinal cohort data to compare children with intellectual disability (ID) in Ireland between 2006 and 2014 on healthcare utilisation and unmet need, at ages 9 and 13, using a propensity score matching (PSM) approach. Methods Using data from the Growing up in Ireland study, PSM was used to identify an appropriate control sample to compare with a sample of children with ID (n = 124). Participants were matched on variables that are known to influence healthcare utilisation to reduce the impact of confounding variables between groups so that differences between the groups can be estimated. Logistic regression was used to estimate effects at ages 9 and 13. ResultsChildren with ID were no more likely to have visited a general practitioner or emergency department in the past 12 months than children without ID. They did have a greater likelihood of visiting a doctor in a hospital in the past 12 months and of having an overnight stay in hospital by age 9. Primary caregivers of children with ID were more likely to report unmet health needs at ages 9 and 13. Conclusions This approach is a novel means of comparing healthcare use in this population by balancing the impact of other factors that may result in inequities, to which children with ID may be more vulnerable.

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Primary Care Enhanced Access Services and the Association With Nonurgent Pediatric Emergency Department Utilization and Child Opportunity Index

Hincapie,

Corbera-Hincapie,

Suresh

et al. 2024

Pediatr Emer Care

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Objectives This study aims to examine the association between primary care practice characteristics (enhanced access services) and practice-level rates of nonurgent emergency department (ED) visits using ED and practice-level data. Survey data suggest that enhanced access services within a child's primary care practice may be associated with reduced nonurgent ED visits. Methods We performed a cross-sectional analysis of nonurgent ED visits to a tertiary pediatric hospital in Western Pennsylvania with nearly 85,000 annual ED visits. We obtained patient encounter data of all nonurgent pediatric ED (PED) visits between January 2018 and December 2019. We identified the primary care provider at the time of the study period. For each of the 42 included offices, we determined the number of unique children in the office with a nonurgent PED visit, allowing us to determine the percentage of children in the practice with such a visit during the study period. We then stratified the 42 offices into low, intermediate, and high tertiles of nonurgent PED use. Using Kruskal-Wallis tests, logistic regression, and Pearson χ2 tests, we compared practice characteristics, enhanced access services, practice location Child Opportunity Index 2.0, and PED visit diagnoses across tertiles. Results We examined 52,459 nonurgent PED encounters by 33,209 unique patients across 42 outpatient offices. Primary care practices in the lowest ED visit tertile were more likely to have 4 or more evenings with office hours (36% vs 14%, P = 0.04), 4 or more evenings of weekday extended hours (43% vs 14%, P = 0.05), and at least 1 day of any weekend hours (86% vs 29%, P = 0.01), compared with practices in other tertiles. High PED use tertile offices were also associated with lower Child Opportunity Index scores. Conclusions Primary care offices with higher nonurgent PED utilization had fewer enhanced access services and were located in neighborhood with fewer child-focused resources.

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Understanding Pediatric Caretakers’ Views on Obtaining Medical Care for Low‐acuity Illness

Cited by 5 publications

References 30 publications

Factors that influence family and parental preferences and decision making for unscheduled paediatric healthcare – systematic review

Factors that influence family and parental preferences and decision making for unscheduled paediatric healthcare – systematic review

Healthcare utilisation and unmet health needs in children with intellectual disability: a propensity score matching approach using longitudinal cohort data

Primary Care Enhanced Access Services and the Association With Nonurgent Pediatric Emergency Department Utilization and Child Opportunity Index

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