Reasons for nonurgent pediatric emergency department visits: perceptions of health care providers and caregivers

Pediatr Emerg Care. 2012 Jan;28(1):43-6. doi: 10.1097/PEC.0b013e31823f2412.

Abstract

Objectives: This study aimed to determine the most important reasons for pediatric nonurgent (NU) emergency department (ED) visits as perceived by caregivers, primary care pediatricians (PCPs), and ED personnel and to assess the differences among these 3 groups in perceived reasons and solutions to NUED visits.

Methods: This study is a cross-sectional survey, with self-administered questionnaires given to caregivers, PCPs, and ED personnel. Responders were asked to rank reasons for NUED visits in order of perceived importance. Opinions on NUED use reduction strategies were also queried.

Results: Although almost 80% of PCPs expected to be called by caregivers before ED visits, fewer than 30% of caregivers were aware of this expectation. The most important reasons for NUED visits from the caregivers' perspective were need for medical attention outside PCP working hours, lack of health insurance, and better hospitality in the ED. For PCPs and ED personnel, the most important reason was the caregivers' lack of knowledge on what constitutes a true emergency. More than 70% of ED personnel and PCPs recommended caregiver education as the solution to NUED visits. Caregivers were more likely to recommend more PCPs with longer working hours (41%) and more EDs (31%).

Conclusions: Misconceptions exist among caregivers, PCPs, and ED personnel on NUED visits. Our findings underscore the need to foster understanding and provide concrete areas for intervention.

MeSH terms

  • Adult
  • Appointments and Schedules
  • Attitude
  • Attitude of Health Personnel
  • Caregivers / psychology*
  • Consumer Behavior
  • Cross-Sectional Studies
  • Emergencies
  • Emergency Service, Hospital* / statistics & numerical data
  • Health Education
  • Health Personnel / psychology*
  • Health Priorities
  • Health Services Needs and Demand
  • Hospitals, Urban / statistics & numerical data
  • Humans
  • Medically Uninsured
  • Motivation*
  • New York City
  • Patient Acceptance of Health Care / psychology*
  • Pediatrics*
  • Referral and Consultation
  • Social Perception
  • Surveys and Questionnaires
  • Workforce