EDUCATIONAL INTERVENTIONS TO ALTER PEDIATRIC EMERGENCY DEPARTMENT UTILIZATION PATTERNS

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.