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Community healthcare appointments as an alternative to emergency department assessment: an exploration of family acceptability and preferences

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Canadian Journal of Emergency Medicine Aims and scope Submit manuscript

Abstract

Purpose

Pediatric emergency departments are overcrowded, in part due to many non-emergent visits. We aimed to assess the proportion of parents interested in leaving the pediatric emergency department (ED) prior to physician assessment if they could be offered a scheduled community healthcare appointment. We explored differences in care children received in the ED stratified by interest in a community healthcare appointment and parents’ reasons when they were not interested.

Methods

We conducted a 14-item survey within the pediatric ED at a Canadian tertiary care teaching hospital to assess parents’ interest if a program offered community healthcare appointments and we determined preferred appointment characteristics. All parents presenting with children triaged as CTAS 2–5 who met eligibility criteria were approached by a research assistant prior to physician assessment. Surveys were paired with the medical chart outlining the care received. Descriptive statistics and a regression model were used to describe characteristics of families and care received among those who were and were not interested in a community healthcare appointment.

Results

In total, 403 surveys were completed. Overall, 236 participants (58.6%; 95% CI 53.8–63.4) were interested in a community healthcare appointment. In general, parents who were interested in a community healthcare appointment were younger and presented with younger children compared to those who were not interested. Among those interested, there was a preference to have the appointment with a pediatrician or family physician, timely access to an appointment, and appointments scheduled outside of regular business hours.

Conclusion

Our study provides evidence that there is interest in an alternative care access model positioned to reduce pediatric ED congestion. We found that parents would be interested in leaving the pediatric ED in favor of a community healthcare appointment, provided it was with a physician and available in a timely manner.

Résumé

Objectif

Les services d’urgences pédiatriques sont surchargés, en partie à cause des nombreuses visites non urgentes. Nous avons cherché à évaluer la proportion de parents désireux de quitter le service des urgences pédiatriques avant l’évaluation du médecin si on leur proposait un rendez-vous dans un centre de soins de santé communautaire. Nous avons étudié les différences dans les soins reçus par les enfants aux urgences en fonction de leur intérêt pour un rendez-vous dans un centre de soins de santé communautaire et des raisons invoquées par les parents lorsqu’ils n’étaient pas intéressés.

Méthodes

Nous avons mené une enquête de 14 points au sein du service des urgences pédiatriques d’un hôpital universitaire canadien de soins tertiaires afin d’évaluer l’intérêt des parents pour un programme offrant des rendez-vous de soins de santé communautaires et nous avons déterminé les caractéristiques des rendez-vous préférés. Tous les parents se présentant avec des enfants triés selon l’ETG 2–5 et répondant aux critères d’éligibilité ont été approchés par un assistant de recherche avant l’évaluation par le médecin. Les questionnaires ont été associés au dossier médical décrivant les soins reçus. Des statistiques descriptives et un modèle de régression ont été utilisés pour décrire les caractéristiques des familles et les soins reçus parmi ceux qui étaient et n’étaient pas intéressés par un rendez-vous en soins de santé communautaire.

Résultats

Au total, 403 enquêtes ont été réalisées. Dans l’ensemble, 236 participants (58,6%; IC à 95% 53,8–63,4) étaient intéressés par un rendez-vous en soins de santé communautaires. En général, les parents intéressés par un rendez-vous dans les soins de santé communautaires étaient plus jeunes et se présentaient avec des enfants plus jeunes que ceux qui n’étaient pas intéressés. Parmi les personnes intéressées, on note une préférence pour un rendez-vous avec un pédiatre ou un médecin de famille, un accès rapide à un rendez-vous et des rendez-vous fixés en dehors des heures normales de bureau.

Conclusions

Notre étude montre qu’il existe un intérêt pour un modèle d’accès aux soins alternatif destiné à réduire l’engorgement des urgences pédiatriques. Nous avons constaté que les parents seraient intéressés à quitter le service d’urgence pédiatrique en faveur d’un rendez-vous de soins de santé communautaires pourvu qu’il soit avec un médecin et disponible en temps opportun.

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Author information

Author notes

  1. Steve Leung and Erica McDonald have contributed equally to this work.

Authors and Affiliations

  1. Department of Pediatric Emergency Medicine, BC Children’s Hospital, Vancouver, BC, Canada

    Steve Leung, Erica McDonald, Amy Watson, Quynh Doan & Neil Desai

  2. University of British Columbia, Vancouver, BC, Canada

    Quynh Doan

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  1. Steve Leung
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Corresponding author

Correspondence to Erica McDonald.

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On behalf of all authors, the corresponding author states that there is no conflict of interest and no financial relationships relevant to this study.

Additional information

Communicated by Simon Berthelot.

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Leung, S., McDonald, E., Watson, A. et al. Community healthcare appointments as an alternative to emergency department assessment: an exploration of family acceptability and preferences. Can J Emerg Med 25, 984–991 (2023). https://doi.org/10.1007/s43678-023-00605-z

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