Factors associated with emergency department utilization for nonurgent pediatric problems

Objective: To identify specific caretaker and utilization characteristics p redictive of the use of the emergency departments (EDs) for nonurgent reaso ns. Each year more than 20 million children in the United States seek medic al care in EDs. Between one third and one half of these visits are for nonu rgent reasons. Design: A descriptive study conducted during a 6-month period. Setting: Two urban hospital EDs. Measure: A questionnaire was designed to elicit information about specific caretaker characteristics and their reasons for using the ED for their chil d's nonurgent medical care. Subjects: Two hundred caretakers and children brought to the ED for nonacut e medical care. Caretakers in this study included mothers (82%) with a mean age of 30 years, single caretakers (70%), and unemployed caretakers (60%). The average age of the children was 6.2 years. Results: Most caretakers (92%) reported having a continuity physician for t heir children. Caretakers who reported being taken to the ED when they were children (P<.002) and those with Medicaid insurance (P<.001) were more lik ely to view the ED as the usual site of care. Being a single parent was a p redictor for nonurgent visits (P<.05). Conclusions: Predicting which caretakers are at risk for using the ED for n onurgent care when their children are sick provides the primary care physic ian a means of identifying specific patients who may benefit from intervent ions designed to promote a more cost-effective approach to using medical re sources.