Factors associated with the inappropriate use of the pediatric emergency department. A systematic review

• Published in: Journal of pediatric nursing 2023-03, Vol.69, p.38-46
• Main Authors: Montoro-Pérez, Néstor, Richart-Martínez, Miguel, Montejano-Lozoya, Raimunda
• Format: Article
• Language: English
• Subjects: Caregivers; Child; Child Health; Emergency medical services; Emergency Service, Hospital; Health care utilization; Hospitalization; Humans; Minor illness; Non-urgent; Parents - psychology; Pediatrics; Psychosocial factors
• ISSN: 0882-5963; 1532-8449
• DOI: 10.1016/j.pedn.2022.12.027

Pediatric emergency department (PED) admissions have risen in recent years, a trend not justified by the severity of the pathologies presented. The aim of this study is to analyse factors related to the inappropriate use of pediatric emergency departments. This is a systematic review reported in accordance with the PRISMA statement. We searched the PubMed, Web of Science and Science Direct databases, using keywords extracted from MeSH, and conducted a reverse search using Google Scholar and Open Grey, for the period January 2017 to August 2022. The quality of the papers was assessed using STROBE, CASPe, AMSTAR-2, GRADE, Levels Of Evidence and Grades Of Recommendation. A total of 20 studies were selected. Factors related to inappropriate use included the younger age of children, black caregivers, lower socioeconomic status, lower parental educational attainment, perceived urgent demand for care, parental emotions in response to their children's health problems, psychological distress, the ineffective exercise of the parental role, the advantages of the PED and the nature of health insurance. The results illustrate the heterogeneous nature of the phenomenon under investigation. Gaining an understanding of the factors related to the inappropriate demand of PEDs, from the perspective of health professionals, can help in developing interventions to reduce unnecessary consultations and relieve pressure on these healthcare services. •This systematic review shows the multifactorial nature of the phenomenon under investigation.•Further research is needed on factors related to parental role.•Analysis of the data suggests that parental support is needed in order to reduce the increasing demand.