Socio-economic composition of low-acuity paediatric presentation at a regional hospital emergency department

Faith O. Alele; Emily J. Callander; Theophilus I. Emeto; Jane Mills; Kerrianne Watt

doi:10.1111/jpc.14079

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Socio-economic composition of low-acuity paediatric presentation at a regional hospital emergency department

Journal article

Peer reviewed

Socio-economic composition of low-acuity paediatric presentation at a regional hospital emergency department

Faith O. Alele, Emily J. Callander, Theophilus I. Emeto, Jane Mills and Kerrianne Watt

Journal of Paediatrics and Child Health, Vol.54(12), pp.1341-1347

2018

DOI: https://doi.org/10.1111/jpc.14079

PMID: 29863756

Abstract

child

pre-school

emergency services

hospital

infant

newborn

social class

Aim: Despite increasing rates of emergency department (ED) utilisation, little is known about low-acuity presentations in children <= 5 years. The aims of the study were to estimate the proportion and cost of low-acuity presentations in children <= 5 years presenting to the ED and to determine the relative effect of socio-economic status (SES) on paediatric low-acuity presentations at the ED. Methods: This is a retrospective observational study of children <= 5 years presenting to the Cairns Hospital ED over 4 years. A multivariate logistic regression model was used to assess the association between SES and low-acuity presentations. Cost of low-acuity presentations was calculated based on triage score and admission status, using costs obtained from the National Hospital Cost Data Collection. Results: A total of 23 086 children were included in the study, of whom 56.7% were male (mean age = 1.85 +/- 1.63 years). Approximately one-third of ED visits were low-acuity presentations (32.4%), and low-acuity presentations increased progressively with SES. In multivariate analysis, children from families with very high SES were twice as likely to have a low-acuity presentation (odds ratio 2.17; 95% confidence interval, 1.66-2.85). Low-acuity ED presentations cost the health-care system in excess of A$895 000-A$1 110 000 per year. Conclusions: These findings demonstrate that a significant proportion of paediatric ED visits are of low acuity and that these visits yield a substantial cost to the health system. Further research is required regarding care givers' rationale and potentially other reasons underlying these low-acuity ED presentations.

Details

Title: Socio-economic composition of low-acuity paediatric presentation at a regional hospital emergency department
Authors: Faith O. Alele (Corresponding Author) - James Cook University
Emily J. Callander (Author) - James Cook University
Theophilus I. Emeto (Author) - James Cook University
Jane Mills (Author) - Massey University
Kerrianne Watt (Author) - James Cook University
Publication details: Journal of Paediatrics and Child Health, Vol.54(12), pp.1341-1347
Publisher: Wiley-Blackwell Publishing Ltd.
DOI: 10.1111/jpc.14079
ISSN: 1440-1754
PMID: 29863756
Organisation Unit: School of Health - Public Health
Language: English
Record Identifier: 99967596102621
Output Type: Journal article