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Adjacent Primary Care May Reduce Less Urgent Pediatric Emergency Department Visits

Ellbrant, Julia LU ; Åkeson, Jonas LU ; Sletten, Helena ; Eckner, Jenny LU and Karlsland Åkeson, Pia LU (2020) In Journal of Primary Care and Community Health 11.
Abstract

Aims: Pediatric emergency department (ED) overcrowding is a challenge. This study was designed to evaluate if a hospital-integrated primary care unit (HPCU) reduces less urgent visits at a pediatric ED. Methods: This retrospective cross-sectional study was carried out at a university hospital in Sweden, where the HPCU, open outside office hours, had been integrated next to the ED. Children seeking ED care during 4-week high- and low-load study periods before (2012) and after (2015) implementation of the HPCU were included. Information on patient characteristics, ED management, and length of ED stay was obtained from hospital data registers. Results: In total, 3216 and 3074 ED patient visits were recorded in 2012 and 2015, respectively.... (More)

Aims: Pediatric emergency department (ED) overcrowding is a challenge. This study was designed to evaluate if a hospital-integrated primary care unit (HPCU) reduces less urgent visits at a pediatric ED. Methods: This retrospective cross-sectional study was carried out at a university hospital in Sweden, where the HPCU, open outside office hours, had been integrated next to the ED. Children seeking ED care during 4-week high- and low-load study periods before (2012) and after (2015) implementation of the HPCU were included. Information on patient characteristics, ED management, and length of ED stay was obtained from hospital data registers. Results: In total, 3216 and 3074 ED patient visits were recorded in 2012 and 2015, respectively. During opening hours of the HPCU, the proportions of pediatric ED visits (28% lower; P <.001), visits in the lowest triage group (36% lower; P <.001), patients presenting with fever (P =.001) or ear pain (P <.001), and nonadmitted ED patients (P =.033), were significantly lower in 2015 than in 2012, whereas the proportion of infants ≤3 months was higher in 2015 (P <.001). Conclusions: By enabling adjacent management of less urgent pediatric patients at adequate lower levels of medical care, implementation of a HPCU outside office hours may contribute to fewer and more appropriate pediatric ED visits.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
children, emergency medical service, pediatrics, primary care, triage, urgency
in
Journal of Primary Care and Community Health
volume
11
publisher
SAGE Publications
external identifiers
  • pmid:32501136
  • scopus:85085994867
ISSN
2150-1319
DOI
10.1177/2150132720926276
language
English
LU publication?
yes
id
9e57556f-ad61-4712-b320-905388b5e629
date added to LUP
2021-01-11 12:24:21
date last changed
2024-03-21 00:57:52
@article{9e57556f-ad61-4712-b320-905388b5e629,
  abstract     = {{<p>Aims: Pediatric emergency department (ED) overcrowding is a challenge. This study was designed to evaluate if a hospital-integrated primary care unit (HPCU) reduces less urgent visits at a pediatric ED. Methods: This retrospective cross-sectional study was carried out at a university hospital in Sweden, where the HPCU, open outside office hours, had been integrated next to the ED. Children seeking ED care during 4-week high- and low-load study periods before (2012) and after (2015) implementation of the HPCU were included. Information on patient characteristics, ED management, and length of ED stay was obtained from hospital data registers. Results: In total, 3216 and 3074 ED patient visits were recorded in 2012 and 2015, respectively. During opening hours of the HPCU, the proportions of pediatric ED visits (28% lower; P &lt;.001), visits in the lowest triage group (36% lower; P &lt;.001), patients presenting with fever (P =.001) or ear pain (P &lt;.001), and nonadmitted ED patients (P =.033), were significantly lower in 2015 than in 2012, whereas the proportion of infants ≤3 months was higher in 2015 (P &lt;.001). Conclusions: By enabling adjacent management of less urgent pediatric patients at adequate lower levels of medical care, implementation of a HPCU outside office hours may contribute to fewer and more appropriate pediatric ED visits.</p>}},
  author       = {{Ellbrant, Julia and Åkeson, Jonas and Sletten, Helena and Eckner, Jenny and Karlsland Åkeson, Pia}},
  issn         = {{2150-1319}},
  keywords     = {{children; emergency medical service; pediatrics; primary care; triage; urgency}},
  language     = {{eng}},
  publisher    = {{SAGE Publications}},
  series       = {{Journal of Primary Care and Community Health}},
  title        = {{Adjacent Primary Care May Reduce Less Urgent Pediatric Emergency Department Visits}},
  url          = {{http://dx.doi.org/10.1177/2150132720926276}},
  doi          = {{10.1177/2150132720926276}},
  volume       = {{11}},
  year         = {{2020}},
}