Vt. Chande et al., EDUCATIONAL INTERVENTIONS TO ALTER PEDIATRIC EMERGENCY DEPARTMENT UTILIZATION PATTERNS, Archives of pediatrics & adolescent medicine, 150(5), 1996, pp. 525-528
Objective: To test the hypothesis that educating parents about use of
their primary care provider and providing information about common ped
iatric illnesses Mill reduce visits to the pediatric emergency departm
ent (FED). Design: Prospective, randomized, controlled trial conducted
from September 1, 1993, to October 31, 1994. Setting: Pediatric emerg
ency department of an urban university hospital. Participants: Parents
of 130 patients seen in the FED for minor illness. Interventions: Sub
jects were randomized to intervention or control groups. Parents in bo
th groups were interviewed about their child's health and use of healt
h care services. The intervention group received education on pediatri
c health care issues; the control group received usual FED discharge i
nstructions. Use of the FED by all subjects was tracked for 6 months b
y telephone follow-up and medical record review. Main Outcome Measures
: Differences between the two groups in total number of return visits
to the FED and return visits to the FED for minor illness. Results: Si
xty-seven (97%) of the 69 patients in the intervention group and 56 (9
2%) of the 61 patients in the control group identified a primary care
provider. At 6-month follow-up, 21 patients (30%) from the interventio
n group and 16 (26%) from the control group had returned to the FED (P
=.68, chi(2)) Seventeen (81%) of intervention group returnees to the F
ED had minor illness, as did 11 (69%) of control group returnees. Conc
lusions: A one-lime educational intervention in the FED does not alter
long-term emergency department utilization habits. More extensive edu
cation and greater availability of primary care providers may be neede
d to decrease use of the FED for minor illness.