The objective of this study was to describe the use of a pediatric eme
rgency department (PED) by children with chronic conditions. The study
design was retrospective and descriptive in an urban tertiary care pe
diatric hospital setting. We reviewed 8561 visits to a PED over a thre
e-month time period. Two thousand twenty-four (24%) of the visits were
by children with one or more chronic conditions, There were no interv
entions, The mean age of the patients was 4.9 years, and 61% were male
, Thirty-one percent of the patients sought care between 8 AM and 5 PM
Monday through Friday, Five subspecialty areas accounted for 86% of t
he chronic conditions seen: asthma (43%), neurology (15%), hematology/
oncology (14%), neurosurgery (10%), and cardiology (4%). Twenty-eight
percent of the chronically ill patients were admitted as compared to 1
1% of the nonchronically ill patients (P < 0.001). One percent of the
chronically ill patients were admitted to the intensive care unit as c
ompared to 0.03% of the nonchronically ill patients (P < 0.0001), It w
as concluded that children with chronic conditions account for one-qua
rter of all FED visits. Sixty-nine percent of those visits were made d
uring evening/nighttime hours or on the weekend. A relatively large pe
rcentage of these children were admitted. The pediatric emergency phys
icians provide an important service to both the children with chronic
conditions and the subspecialists who care for them. PEDs mag need to
refine emergency department systems to serve this group of patients as
efficiently and effectively as possible.