APPROPRIATE USE OF A PEDIATRIC EMERGENCY DEPARTMENT - IS THE PEDIATRICIAN CALLED BEFORE THE VISIT

The objective of this study was to examine the appropriateness of util ization of an urban pediatric emergency department (ED) by children wh o had a pediatrician and factors relating to whether the pediatrician was called before an ED visit. This was done prospectively and randoml y in an urban teaching hospital pediatric ED. One hundred and sixty-si x patients, 18 years old and younger, who presented for nontraumatic c onditions and had a pediatrician, classified as private or nonprivate, were enrolled. A questionnaire was completed and appropriateness of v isit was determined using previously published criteria. No difference in appropriateness of visit was found between private and nonprivate patients (58/98, 40/68, NS). Thirty-five of 54 (65%) parents who calle d their pediatrician were classified as an appropriate ED visit as opp osed to 62 of 112 who did not call (55%, NS). Private patients called their physicians more often then nonprivate patients (P < 0.001). Lack of access to their primary care providers was the more common reason among nonprivate patients (P < 0.05) for not calling their pediatricia ns. We conclude that appropriateness of pediatric ED visits is indepen dent of type of physician. Nonprivate patients tend to consult their p hysician less often before ED visits because of access problems.