Why Do Parents Bring Children to the Emergency Department for Nonurgent Conditions? A Qualitative Study
Received 18 March 2008; accepted 11 July 2008. published online 06 October 2008.
Objective
Nonurgent conditions account for 58% to 82% of pediatric emergency department (ED) visits, but only 1 preliminary qualitative study has examined reasons why parents bring children to the ED for nonurgent care. The aim of this study was to identify parents’ reasons for choosing the ED over their primary care provider (PCP) for nonurgent pediatric care.
Methods
Audiotaped ethnographic interviews in English and Spanish were conducted of parents of children presenting for nonurgent care on weekdays from 8 AM to 4 PM at a children's hospital ED over a 4-week period.
Results
For the 31 families interviewed, the mean parental age was 28 years, and mean child age, 3 years. Reasons cited by caregivers for choosing the ED over their child's PCP were long appointment waits, dissatisfaction with the PCP, communication problems (accents and unhelpful staff at PCP), health care provider referral, efficiency, ED resources, convenience, quality of care, and ED expertise with children. Some parents said they would like education on the urgency of pediatric problems.
Conclusions
Parents bring their children to the ED for nonurgent care because of problems with their PCP, PCP referral, and perceived advantages to ED care. Although parents report that education on the urgency of pediatric conditions would be helpful, substantial reduction of pediatric nonurgent ED use may require improvements in families’ PCP office access, efficiency, experiences, and appointment scheduling.
From the Pennsylvania State College of Medicine, Hershey, Pa (Ms Berry); Section of Emergency Medicine, Department of Pediatrics, Medical College of Wisconsin, Children's Research Institute, Children's Hospital of Wisconsin, Department of Population Health, Medical College of Wisconsin, Milwaukee, Wis (Dr Brousseau); Division of General Pediatrics, Department of Pediatrics, University of Texas Southwestern Medical Center (Dr Brotanek and Dr Flores); Children's Medical Center, Dallas, Tex (Dr Brotanek and Dr Flores); and Signature Science LLC, Austin, Tex (Ms Tomany-Korman)
Address correspondence to Jane M. Brotanek, MD, MPH, Department of Pediatrics, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, Texas 75390-9063.
Presented in part at the Pediatric Academic Societies' Annual Meeting, San Francisco, Calif, May 2, 2006; AcademyHealth, Seattle, Wash, June 25, 2006; and American Public Health Association, Boston, Mass, November 7, 2006.
ABSTRACT