Socioeconomic deprivation and vulnerability in the pediatric emergency unit: evaluation and management.

Objective. - The aim of this study was to evaluate the importance of socioe conomic deprivation and other forms of vulnerability in families attending the pediatric emergency unit (PEU). It was based on a five-level classifica tion of family types and an analysis of responses provided by the French he althcare system. Method. - The prospective study involved 150 families admitted to the PEU o n the basis of open-response interviews that analyzed demographic and socio -economic characteristics, motivations for consultation, the child's qualit y of life, family problems experienced by the parents, and their support ne twork. Results. - Five categories of families were defined as follows: complete de stitution necessitating immediate social measures (0.7%); acknowledged and well-managed economic deprivation (13.3%), unacknowledged and/or complex ec onomic deprivation with a significant deterioration in the quality of life (22.2%), familial psychological vulnerability without economic deprivation (30.4%), and families without any apparent problems (33.7%). Consultation a t the PEU appears to be a multifactorial phenomenon motivated by socioecono mic, psychological and cultural factors. This phenomenon is connected with the present-day imbalance in the healthcare system, which does not adequate ly respond to the needs of vulnerable families. Conclusion. - This survey contributes to the current reflection on the inte gration of psychosocial factors in child healthcare at both the hospital an d local community level. The method described herein has determined the fac tors of vulnerability and the risks of economic deprivation. It can contrib ute to the development of improved communication and cooperation between pr actitioners, the hospital and local social workers. (C) 2001 Editions scien tifiques et medicales Elsevier SAS.