Advertisement

European Journal of Pediatrics

, Volume 172, Issue 6, pp 797–802 | Cite as

Multiple health care visits related to a pediatric emergency visit for young children with common illnesses

  • F. AngoulvantEmail author
  • S. Jumel
  • S. Prot-Labarthe
  • X. Bellettre
  • M. Kahil
  • A. Smail
  • L. Morin
  • C. Alberti
Original Article

Abstract

We aim to describe the number of health care visits before and after pediatric emergency department (PED) visits for common illnesses in a French tertiary pediatric hospital. This was a prospective cohort study with 501 children under 6 years of age who were evaluated and discharged from a tertiary care PED. Enrollment occurred on eight randomly selected study days between November 2010 and June 2011. The caregivers were then contacted via telephone 8 days later to obtain follow-up data, including information about return visits to health care facilities. Multiple visits were made by 206 (41 %) children, previous visits had occurred for 139 (28 %) children, and return visits had occurred for 94 (19 %) children. Previous and return visits were made at the PED as well as in general practitioners’ offices and private pediatric offices. The median age of the subjects was 18 months. Fever was the most common complaint and was associated with more frequent multiple heath care visits. Conclusion: Multiple heath care visits for the same illness are frequent, especially for febrile children. Interestingly, this phenomenon concerns every type of health care facility, including the PED, general practitioners’ offices, and private pediatric offices. Further studies should be performed to achieve a better understanding of this phenomenon and to test specific interventions, such as parental education and improvement of the information system.

Keywords

Return visits Health care Crowding Pediatric emergency 

Notes

Acknowledgments

We thank Pr Jean-Christophe Mercier for his careful reading.

Funding

None.

Conflict of interest

None.

References

  1. 1.
    Alessandrini EA, Lavelle JM, Grenfell SM, Jacobstein CR, Shaw KN (2004) Return visits to a pediatric emergency department. Pediatr Emerg Care 20:166–171PubMedCrossRefGoogle Scholar
  2. 2.
    Alpern ER, Stanley RM, Gorelick MH, Donaldson A, Knight S, Teach SJ, Singh T, Mahajan P, Goepp JG, Kuppermann N, Dean JM, Chamberlain JM (2006) Epidemiology of a pediatric emergency medicine research network: the PECARN Core Data Project. Pediatr Emerg Care 22:689–699PubMedCrossRefGoogle Scholar
  3. 3.
    Asplin BR, Magid DJ, Rhodes KV, Solberg LI, Lurie N, Camargo CA Jr (2003) A conceptual model of emergency department crowding. Ann Emerg Med 42:173–180PubMedCrossRefGoogle Scholar
  4. 4.
    Enarson MC, Ali S, Vandermeer B, Wright RB, Klassen TP, Spiers JA (2012) Beliefs and expectations of Canadian parents who bring febrile children for medical care. Pediatrics 130:e905–e912. doi: 10.1542/peds.2011-2140 PubMedCrossRefGoogle Scholar
  5. 5.
    Finkelstein JA, Christiansen CL, Platt R (2000) Fever in pediatric primary care: occurrence, management, and outcomes. Pediatrics 105:260–266PubMedGoogle Scholar
  6. 6.
    Goldman RD, Ong M, Macpherson A (2006) Unscheduled return visits to the pediatric emergency department-one-year experience. Pediatr Emerg Care 22:545–549PubMedCrossRefGoogle Scholar
  7. 7.
    Gordon JA, An LC, Hayward RA, Williams BC (1998) Initial emergency department diagnosis and return visits: risk versus perception. Ann Emerg Med 32:569–573PubMedCrossRefGoogle Scholar
  8. 8.
    Jacobstein CR, Alessandrini EA, Lavelle JM, Shaw KN (2005) Unscheduled revisits to a pediatric emergency department: risk factors for children with fever or infection-related complaints. Pediatr Emerg Care 21:816–821PubMedCrossRefGoogle Scholar
  9. 9.
    Jayaprakash N, O'Sullivan R, Bey T, Ahmed SS, Lotfipour S (2009) Crowding and delivery of healthcare in emergency departments: the European perspective. West J Emerg Med 10:233–239PubMedGoogle Scholar
  10. 10.
    Klein-Kremer A, Goldman RD (2011) Return visits to the emergency department among febrile children 3 to 36 months of age. Pediatr Emerg Care 27:1126–1129PubMedCrossRefGoogle Scholar
  11. 11.
    Massin MM, Montesanti J, Gerard P, Lepage P (2006) Spectrum and frequency of illness presenting to a pediatric emergency department. Acta Clin Belg 61:161–165PubMedGoogle Scholar
  12. 12.
    Mistry RD, Stevens MW, Gorelick MH (2007) Short-term outcomes of pediatric emergency department febrile illnesses. Pediatr Emerg Care 23:617–623PubMedCrossRefGoogle Scholar
  13. 13.
    Moskop JC, Sklar DP, Geiderman JM, Schears RM, Bookman KJ (2009) Emergency department crowding, part 1—concept, causes, and moral consequences. Ann Emerg Med 53:605–611PubMedCrossRefGoogle Scholar
  14. 14.
    Sharma V, Simon SD, Bakewell JM, Ellerbeck EF, Fox MH, Wallace DD (2000) Factors influencing infant visits to emergency departments. Pediatrics 106:1031–1039PubMedCrossRefGoogle Scholar
  15. 15.
    Sinclair D (2007) Emergency department overcrowding—implications for paediatric emergency medicine. Paediatr Child Health 12:491–494PubMedGoogle Scholar
  16. 16.
    Stang AS, McGillivray D, Bhatt M, Colacone A, Soucy N, Leger R, Afilalo M (2010) Markers of overcrowding in a pediatric emergency department. Acad Emerg Med 17:151–156PubMedCrossRefGoogle Scholar
  17. 17.
    Zimmerman DR, McCarten-Gibbs KA, DeNoble DH, Borger C, Fleming J, Hsieh M, Langer JC, Breckenridge MB (1996) Repeat pediatric visits to a general emergency department. Ann Emerg Med 28:467–473PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • F. Angoulvant
    • 1
    • 2
    Email author
  • S. Jumel
    • 1
  • S. Prot-Labarthe
    • 3
  • X. Bellettre
    • 1
  • M. Kahil
    • 1
  • A. Smail
    • 1
  • L. Morin
    • 1
  • C. Alberti
    • 2
  1. 1.Service d’Accueil des Urgences PédiatriquesAP-HP, Hôpital Robert DebréParisFrance
  2. 2.Unité d’épidémiologie cliniqueAP-HP, Hôpital Robert DebréParisFrance
  3. 3.Département de PharmacieAP-HP, Hôpital Robert DebréParisFrance

Personalised recommendations