ADOLESCENT HEALTH-CARE IN A PEDIATRIC EMERGENCY DEPARTMENT

Study objective: We examined the use of the pediatric emergency depart ment of an urban children's hospital by adolescents. The study include d visits by all adolescents aged 13 to 18 years in a 1-week period fro m each season during 1992. Results: The ED saw 426 adolescents, repres enting approximately 15% of the total ED visits. Fifty percent of thes e patients were male. More than half of the patients were black; a few were members of other minority groups. Eighteen percent had emergency , 60% urgent, and 21% nonurgent conditions. Forty three percent of the patients came to the ED between 3 PM and 11 PM. Injuries accounted fo r 47% of male visits and 42% of female visits. Approximately half of t he injuries resulted from violent events. Twenty-seven percent of the visits were for exacerbation of a chronic illness such as asthma or di abetes. The most common reason for adolescent female visits was gyneco logic problems. Injury was the most common reason for adolescent male visits. Only 27% of the adolescents lived in a two-parent home. In 16% of the cases, the adolescents were treated without consent. Nineteen percent of the adolescents were uninsured, and nearly 50% were publicl y insured. Conclusion: Issues of violence, consent, and insurance pres ent problems for many adolescents in the pediatric ED. Injuries, parti cularly those related to violent events, are cause for many adolescent visits. ED staff members should develop plans to care for the complex psychosocial and medical problems of adolescents.