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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...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2018
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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 |
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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 |
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