CHILDREN WITH CHRONIC CONDITIONS IN A PEDIATRIC EMERGENCY DEPARTMENT

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.