Cargando…

Emergency department use by paediatric patients in Lombardy Region, Italy: a population study

OBJECTIVES: To estimate the rate of paediatric attendance at emergency departments (EDs) in the Lombardy Region, Italy, and to determine the factors contributing to different patterns of use. METHODS: By analysing healthcare administrative databases, ED attendance by 1.6 million youths <18 years...

Descripción completa

Detalles Bibliográficos
Autores principales: Riva, Benedetta, Clavenna, Antonio, Cartabia, Massimo, Bortolotti, Angela, Fortino, Ida, Merlino, Luca, Biondi, Andrea, Bonati, Maurizio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6014225/
https://www.ncbi.nlm.nih.gov/pubmed/29942865
http://dx.doi.org/10.1136/bmjpo-2017-000247
_version_ 1783334191393406976
author Riva, Benedetta
Clavenna, Antonio
Cartabia, Massimo
Bortolotti, Angela
Fortino, Ida
Merlino, Luca
Biondi, Andrea
Bonati, Maurizio
author_facet Riva, Benedetta
Clavenna, Antonio
Cartabia, Massimo
Bortolotti, Angela
Fortino, Ida
Merlino, Luca
Biondi, Andrea
Bonati, Maurizio
author_sort Riva, Benedetta
collection PubMed
description OBJECTIVES: To estimate the rate of paediatric attendance at emergency departments (EDs) in the Lombardy Region, Italy, and to determine the factors contributing to different patterns of use. METHODS: By analysing healthcare administrative databases, ED attendance by 1.6 million youths <18 years old during 2012 in the Lombardy Region was assessed. The pattern of use was categorised based on the number of ED visits and level of emergency, defined by triage code and outcome of the visit. Logistic regression analyses were performed to identify the characteristics of access for non-urgent reasons and those of patients with frequent non-urgent access (≥4 accesses for non-urgent reasons only). A case–control study was carried out to compare healthcare resource use by children 1–5 years old who were ‘frequent non-urgent users’ with that of randomly selected controls, matched by age, gender, nationality and primary care physician. RESULTS: During 2012, 440 284 (27%) of children and adolescents had at least one ED attendance, with trauma (26%) and respiratory tract infections (22%) as the most frequent diagnoses. In all, 533 037 (79%) accesses were for non-urgent reasons, and 12 533 (3% of the ED users) were frequent non-urgent users. Male gender (OR 1.12; 95% CI 1.08 to 1.17), preschool age (OR 3.14; 95% CI 2.98 to 3.31) and place of residence (OR 1.74; 95% CI 1.70 to 1.99) were associated with a higher risk of being a frequent non-urgent user. Moreover, a greater healthcare consumption was observed in this group. CONCLUSIONS: One out of four children and adolescents attended the ED at least once per year, 3% of whom were frequent non-urgent users, with a high overall healthcare resource consumption.
format Online
Article
Text
id pubmed-6014225
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher BMJ Publishing Group
record_format MEDLINE/PubMed
spelling pubmed-60142252018-06-25 Emergency department use by paediatric patients in Lombardy Region, Italy: a population study Riva, Benedetta Clavenna, Antonio Cartabia, Massimo Bortolotti, Angela Fortino, Ida Merlino, Luca Biondi, Andrea Bonati, Maurizio BMJ Paediatr Open Original Article OBJECTIVES: To estimate the rate of paediatric attendance at emergency departments (EDs) in the Lombardy Region, Italy, and to determine the factors contributing to different patterns of use. METHODS: By analysing healthcare administrative databases, ED attendance by 1.6 million youths <18 years old during 2012 in the Lombardy Region was assessed. The pattern of use was categorised based on the number of ED visits and level of emergency, defined by triage code and outcome of the visit. Logistic regression analyses were performed to identify the characteristics of access for non-urgent reasons and those of patients with frequent non-urgent access (≥4 accesses for non-urgent reasons only). A case–control study was carried out to compare healthcare resource use by children 1–5 years old who were ‘frequent non-urgent users’ with that of randomly selected controls, matched by age, gender, nationality and primary care physician. RESULTS: During 2012, 440 284 (27%) of children and adolescents had at least one ED attendance, with trauma (26%) and respiratory tract infections (22%) as the most frequent diagnoses. In all, 533 037 (79%) accesses were for non-urgent reasons, and 12 533 (3% of the ED users) were frequent non-urgent users. Male gender (OR 1.12; 95% CI 1.08 to 1.17), preschool age (OR 3.14; 95% CI 2.98 to 3.31) and place of residence (OR 1.74; 95% CI 1.70 to 1.99) were associated with a higher risk of being a frequent non-urgent user. Moreover, a greater healthcare consumption was observed in this group. CONCLUSIONS: One out of four children and adolescents attended the ED at least once per year, 3% of whom were frequent non-urgent users, with a high overall healthcare resource consumption. BMJ Publishing Group 2018-05-30 /pmc/articles/PMC6014225/ /pubmed/29942865 http://dx.doi.org/10.1136/bmjpo-2017-000247 Text en © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Original Article
Riva, Benedetta
Clavenna, Antonio
Cartabia, Massimo
Bortolotti, Angela
Fortino, Ida
Merlino, Luca
Biondi, Andrea
Bonati, Maurizio
Emergency department use by paediatric patients in Lombardy Region, Italy: a population study
title Emergency department use by paediatric patients in Lombardy Region, Italy: a population study
title_full Emergency department use by paediatric patients in Lombardy Region, Italy: a population study
title_fullStr Emergency department use by paediatric patients in Lombardy Region, Italy: a population study
title_full_unstemmed Emergency department use by paediatric patients in Lombardy Region, Italy: a population study
title_short Emergency department use by paediatric patients in Lombardy Region, Italy: a population study
title_sort emergency department use by paediatric patients in lombardy region, italy: a population study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6014225/
https://www.ncbi.nlm.nih.gov/pubmed/29942865
http://dx.doi.org/10.1136/bmjpo-2017-000247
work_keys_str_mv AT rivabenedetta emergencydepartmentusebypaediatricpatientsinlombardyregionitalyapopulationstudy
AT clavennaantonio emergencydepartmentusebypaediatricpatientsinlombardyregionitalyapopulationstudy
AT cartabiamassimo emergencydepartmentusebypaediatricpatientsinlombardyregionitalyapopulationstudy
AT bortolottiangela emergencydepartmentusebypaediatricpatientsinlombardyregionitalyapopulationstudy
AT fortinoida emergencydepartmentusebypaediatricpatientsinlombardyregionitalyapopulationstudy
AT merlinoluca emergencydepartmentusebypaediatricpatientsinlombardyregionitalyapopulationstudy
AT biondiandrea emergencydepartmentusebypaediatricpatientsinlombardyregionitalyapopulationstudy
AT bonatimaurizio emergencydepartmentusebypaediatricpatientsinlombardyregionitalyapopulationstudy