Why do children present to emergency departments? Exploring motivators and measures of presentation appropriateness for children presenting to a paediatric emergency department

Aim To compare the parental motivators and referring general practitioner's (GP's) reasons for advising emergency department (ED) attendance with the assessment of ED medical staff. To compare ED clinician opinion with other published methods that have attempted to define ‘primary care sui...

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Bibliographic Details
Published in:Journal of paediatrics and child health 2017-05, Vol.53 (5), p.451-457
Main Authors: Cheek, John A, Braitberg, George, Craig, Simon, West, Adam
Format: Article
Language:English
Subjects:
Adolescent
Attitude to Health
Child
Child, Preschool
emergency department
Emergency medical care
Emergency Service, Hospital - statistics & numerical data
Emergency Service, Hospital - utilization
Female
General Practice
Health Care Surveys
Health Services Accessibility - statistics & numerical data
Humans
Infant
Infant, Newborn
Male
Motivation
paediatric
parents
Parents - psychology
Pediatrics
Physicians
Primary care
Primary Health Care - statistics & numerical data
Primary Health Care - utilization
Prospective Studies
Referral and Consultation - statistics & numerical data
Victoria
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Summary:Aim To compare the parental motivators and referring general practitioner's (GP's) reasons for advising emergency department (ED) attendance with the assessment of ED medical staff. To compare ED clinician opinion with other published methods that have attempted to define ‘primary care suitable' presentations to the ED. Methods A prospective observational study and series of surveys regarding the attendance of children presenting to a single tertiary paediatric ED. Surveys were distributed to the treating ED clinician, the child's parent/guardian, and the referring GP. Results between the three groups were analysed and compared. Results There were a total of 1069 presentations during the study period. Six hundred (58.4%, 95% CI 55.3–61.4%) presentations were judged as ‘ED appropriate’ by the treating ED clinician. When compared with methods used to retrospectively judge whether ED patients are considered ‘primary care suitable’, ED clinicians disagree between 22.4 and 38.8% of the time. For patients who presented directly to ED, 85.6% did so for a medical reason, whilst 32.1% did so for a GP access reason. Being referred by a GP improved the ED clinicians’ opinion of the appropriateness of the presentation (49.2 vs. 73.9%, P 
ISSN:1034-4810
1440-1754
DOI:10.1111/jpc.13482