TY - JOUR
T1 - Adjacent Primary Care May Reduce Less Urgent Pediatric Emergency Department Visits
AU - Ellbrant, Julia
AU - Åkeson, Jonas
AU - Sletten, Helena
AU - Eckner, Jenny
AU - Karlsland Åkeson, Pia
PY - 2020
Y1 - 2020
N2 - Aims: Pediatric emergency department (ED) overcrowding is a challenge. This study was designed to evaluate if a hospital-integrated primary care unit (HPCU) reduces less urgent visits at a pediatric ED. Methods: This retrospective cross-sectional study was carried out at a university hospital in Sweden, where the HPCU, open outside office hours, had been integrated next to the ED. Children seeking ED care during 4-week high- and low-load study periods before (2012) and after (2015) implementation of the HPCU were included. Information on patient characteristics, ED management, and length of ED stay was obtained from hospital data registers. Results: In total, 3216 and 3074 ED patient visits were recorded in 2012 and 2015, respectively. During opening hours of the HPCU, the proportions of pediatric ED visits (28% lower; P <.001), visits in the lowest triage group (36% lower; P <.001), patients presenting with fever (P =.001) or ear pain (P <.001), and nonadmitted ED patients (P =.033), were significantly lower in 2015 than in 2012, whereas the proportion of infants ≤3 months was higher in 2015 (P <.001). Conclusions: By enabling adjacent management of less urgent pediatric patients at adequate lower levels of medical care, implementation of a HPCU outside office hours may contribute to fewer and more appropriate pediatric ED visits.
AB - Aims: Pediatric emergency department (ED) overcrowding is a challenge. This study was designed to evaluate if a hospital-integrated primary care unit (HPCU) reduces less urgent visits at a pediatric ED. Methods: This retrospective cross-sectional study was carried out at a university hospital in Sweden, where the HPCU, open outside office hours, had been integrated next to the ED. Children seeking ED care during 4-week high- and low-load study periods before (2012) and after (2015) implementation of the HPCU were included. Information on patient characteristics, ED management, and length of ED stay was obtained from hospital data registers. Results: In total, 3216 and 3074 ED patient visits were recorded in 2012 and 2015, respectively. During opening hours of the HPCU, the proportions of pediatric ED visits (28% lower; P <.001), visits in the lowest triage group (36% lower; P <.001), patients presenting with fever (P =.001) or ear pain (P <.001), and nonadmitted ED patients (P =.033), were significantly lower in 2015 than in 2012, whereas the proportion of infants ≤3 months was higher in 2015 (P <.001). Conclusions: By enabling adjacent management of less urgent pediatric patients at adequate lower levels of medical care, implementation of a HPCU outside office hours may contribute to fewer and more appropriate pediatric ED visits.
KW - children
KW - emergency medical service
KW - pediatrics
KW - primary care
KW - triage
KW - urgency
UR - http://www.scopus.com/inward/record.url?scp=85085994867&partnerID=8YFLogxK
U2 - 10.1177/2150132720926276
DO - 10.1177/2150132720926276
M3 - Article
C2 - 32501136
AN - SCOPUS:85085994867
SN - 2150-1319
VL - 11
JO - Journal of Primary Care and Community Health
JF - Journal of Primary Care and Community Health
ER -