Characteristics of frequent pediatric emergency department users at a tertiary university hospital

Objective:
Frequent emergency department (ED) visit is a global public health problem that can delay proper management and reduce the quality of medical services. While many researches were done on adult frequent ED users, studies lack on pediatric patients. This study was designed to identify the characteristics of the frequent pediatric ED users and risk factors related to pediatric frequent ED visits.
Method:
This was a retrospective observational study using ED-based data derived from pediatric patients at a tertiary university hospital. The main exposure variable was frequent pediatric ED visits, which were defined as more than 4 visits within a year (January 1-December 31, 2019). Characteristics and risk factors for frequent pediatric ED users were evaluated using forward stepwise regression analysis.
Results:
During the study period, 10,050 pediatric ED visits (8,313 patients) were identified. Of which, 550 (5.5%) were frequent ED visits (114 patients, 1.4%). The independent risk factors for frequent pediatric ED visits were age <1 year (adjusted odds ratio [AOR], 2.79; 95% confidence interval [CI], 1.32-5.93), visiting during spring and winter (AOR, 5.72; 95% CI, 3.36-9.75) and visiting due to medical problem (AOR, 1.66; 95% CI, 1.02-3.08). Primary diagnosis of unspecified convulsions, acute lower respiratory infection, other specified medical care, and arrhythmia were associated with frequent pediatric ED visits.
Conclusion:
Age <1 year, visiting ED during spring and winter, visiting ED due to medical problem can increase the risk of frequent ED visit by pediatric patients.

Key words: Pediatric emergency department; Crowding; Risk factors