Pediatric use of emergency departments

This cross-sectional survey examined the use of emergency services by children, from birth to 16 years of age, in two urban teaching hospitals. A retrospective chart survey design was used to obtain data on the prevalence of types of patient problems; the pattern of use, including time of day and day of week; and decisions regarding patient disposition. A random sample of 10% of the average monthly pediatric emergency visits was obtained for a 12-month period and relevant data were extracted by trained research assistants. Variation in the presenting health care problems by age group, season of the year, and by time of day and day of the week was found. Approximately 50% of visits involved such primary health care problems as soft tissue injuries, and respiratory and digestive tract infections. Possible reasons for this use of emergency departments for primary care needs are discussed and strategies are suggested for the provision of a better "fit" between consumer demand and health care services.