Characteristics of frequently attending children in hospital emergency departments: a systematic review
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Objective: To summarise the literature on frequent attendances to hospital emergency departments and describe sociodemographic and clinical characteristics of children who attend EDs frequently.
Setting: Hospital emergency departments.
Participants: Children <21 years, attending hospital emergency departments frequently.
Primary outcome measures: Outcomes measures were defined separately in each study, and were predominantly the number of ED attendances per year.
Results: We included 21 studies representing 6,513,627 children. Between 0.3% to 75% of all paediatric ED users were frequent users. Most studies defined 4 or more visits per year as a “frequent ED” usage. Children who were frequent ED users were more likely to be less than 5 years old. In the US, patients with public insurance were more likely to be frequent attenders. Frequent ED users more likely to be frequent users of primary care and have long-term conditions; the most common diagnoses were infections and gastroenteritis.
Conclusions: The review included a wide range of information across various health systems, however children who were frequent ED users have some universal characteristics in common. Policies to reduce frequent attendance might usefully focus on preschool children and supporting primary care in responding to primary-care oriented conditions.
Setting: Hospital emergency departments.
Participants: Children <21 years, attending hospital emergency departments frequently.
Primary outcome measures: Outcomes measures were defined separately in each study, and were predominantly the number of ED attendances per year.
Results: We included 21 studies representing 6,513,627 children. Between 0.3% to 75% of all paediatric ED users were frequent users. Most studies defined 4 or more visits per year as a “frequent ED” usage. Children who were frequent ED users were more likely to be less than 5 years old. In the US, patients with public insurance were more likely to be frequent attenders. Frequent ED users more likely to be frequent users of primary care and have long-term conditions; the most common diagnoses were infections and gastroenteritis.
Conclusions: The review included a wide range of information across various health systems, however children who were frequent ED users have some universal characteristics in common. Policies to reduce frequent attendance might usefully focus on preschool children and supporting primary care in responding to primary-care oriented conditions.
Date Issued
2021-10-18
Date Acceptance
2021-08-23
Citation
BMJ Open, 2021, 11 (10), pp.1-7
ISSN
2044-6055
Publisher
BMJ Journals
Start Page
1
End Page
7
Journal / Book Title
BMJ Open
Volume
11
Issue
10
Copyright Statement
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/
This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
License URL
Sponsor
National Institute of Health and Medical Research
NIHR
Identifier
https://bmjopen.bmj.com/content/11/10/e051409
Grant Number
NIHR200180
Subjects
Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
accident & emergency medicine
paediatric intensive & critical care
paediatric A&E and ambulatory care
HEALTH
accident & emergency medicine
paediatric A&E and ambulatory care
paediatric intensive & critical care
1103 Clinical Sciences
1117 Public Health and Health Services
1199 Other Medical and Health Sciences
Publication Status
Published
Date Publish Online
2021-10-18