Drivers for low-acuity pediatric emergency department visits in two tertiary hospitals in Switzerland: a cross-sectional, questionnaire-based study.

Détails

Ressource 1Télécharger: Jaboyedoff et al. - 2024 - Drivers for low-acuity pediatric emergency departm.pdf (841.70 [Ko])
Etat: Public
Version: Final published version
Licence: CC BY 4.0
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Télécharger: 12913_2023_10348_MOESM1_ESM (2).pdf (116.51 [Ko])
Etat: Public
Version: de l'auteur⸱e
Licence: Non spécifiée
ID Serval
serval:BIB_F1A5D67DA527
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Drivers for low-acuity pediatric emergency department visits in two tertiary hospitals in Switzerland: a cross-sectional, questionnaire-based study.
Périodique
BMC health services research
Auteur⸱e⸱s
Jaboyedoff M., Starvaggi C., Suris J.C., Kuehni C.E., Gehri M., Keitel K.
ISSN
1472-6963 (Electronic)
ISSN-L
1472-6963
Statut éditorial
Publié
Date de publication
18/01/2024
Peer-reviewed
Oui
Volume
24
Numéro
1
Pages
103
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: epublish
Résumé
Low-acuity pediatric emergency department (PED) visits are frequent in high-income countries and have a negative impact on patient care at the individual and health system levels. Knowing what drives low-acuity PED visits is crucial to inform adaptations in health care delivery. We aimed to identify factors associated with low-acuity PED visits in Switzerland, including socioeconomic status, demographic features, and medical resources of families.
We conducted a prospective, questionnaire-based study in the PEDs of two Swiss tertiary care hospitals, Bern and Lausanne. We invited all consecutive children and their caregiver attending the PED during data collection times representative of the overall PED consultation structure (e.g. day/night, weekdays/weekends) to complete a questionnaire on demographic features, socioeconomic status, and medical resources. We collected medical and administrative data about the visit and defined low-acuity visits as those meeting all of the following criteria: (1) triage category 4 or 5 on the Australasian Triage Scale, (2) no imaging or laboratory test performed, and (3) discharge home. We used a binary multiple logistic regression model to identify factors associated with low-acuity visits.
We analysed 778 PED visits (September 2019 to July 2020). Most children visiting our PEDs had a designated primary care provider (92%), with only 6% not having seen them during the last year. Fifty-five per cent of caregivers had asked for medical advice before coming to the PED. The proportion of low-acuity visits was 58%. Low-acuity visits were associated with caregiver's difficulties paying bills (aOR 2.6, 95% CI 1.6 - 4.4), having already visited a PED in the last 6 months (aOR 1.7, 95% CI 1.1 - 2.5) but not with parental education status, nor parental country of birth, parental employment status or absence of family network.
Economic precariousness is an important driver for low-acuity PED visits in Switzerland, a high-income country with compulsory health coverage where most children have a designated primary care provider and a regular pediatric follow-up. Primary care providers and PEDs should screen families for economic precariousness and offer anticipatory guidance and connect those in financial need to social support.
Mots-clé
Child, Humans, Tertiary Care Centers, Switzerland, Cross-Sectional Studies, Prospective Studies, Emergency Room Visits, Surveys and Questionnaires, Emergency Service, Hospital, Hospitals, Pediatric, Healthcare use, Low-acuity, Non-urgent, Pediatric emergency department, Socioeconomic status
Pubmed
Web of science
Open Access
Oui
Création de la notice
22/01/2024 16:02
Dernière modification de la notice
18/07/2024 7:20
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