International Society for Research14th Annual European Congress58 November 2011 Madrid SpainAUTHORSBenahmed N Laokri S Zhang WH Cohen L Alexander S De Wever ACREGSI Research Center for Health Economi ID: 898554
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1 THE APPROPRIATE USE OF THE EMERGENCY DEP
THE APPROPRIATE USE OF THE EMERGENCY DEPARTMENT FOR PAEDIATRIC PATIENTS International Society for Research14th Annual European Congress5-8 November 2011, Madrid, Spain AUTHORSBenahmed N.*, Laokri S.*, Zhang WH.**, Cohen L.*, Alexander S.**, De Wever A.*CREGSI (Research Center for Health Economics, Health Facilities Management and Nursing Sciences), School of Public Health, Université Libre de Bruxelles (ULB), BelgiumPerinatal Epidemiology and Reproductive Health Unit, School of Public Health, Université Libre de Bruxelles (ULB), Belgium AUTHOR nadia.ben.hamed@ulb.ac.beBePASSTABelgian paediatric short stay study To determine the factors associated with paediatric inappropriate use (IU) of the accident and emergency department (A&E). An observational prospective survey was performed. All the patients (6 years) attending A&E in 12 Belgian hospitals during 2 weeks in 2010 were included. The use of A&E was considered appropriate if, at least, one of the following criteria was met: child referred by a doctor or the police, brought by ambulance, need for a short stay, need for technical examination or orthopaedic treatment, in patient admission, death. Short stay includes any A&E attendance where duration is between 4 and 24 hours. Overall, 3220 children were included in study, the median age was 3.3 years old (0-15.9). Among of 3220 children, 39.3% of the visits were not appropriate according to the definition. Five determinants were included in a multivariateanalyze: age, having a family doctor, night or week-end use of A&E, parents’ perception of severity for child’s illness and insurance status. The factors associated with the IU are presented in Table 1. LUSIONSIn a country without proper gatekeeping or referral system, like in Belgium, four out of ten children’s ED visits were considered as inappropriate. The risk of IU is mainly due to the failure of relevant alternative for children years and for night and weekend users. Two other factors associated to an increased IU were: short distance from home to ED and having a family doctor. Parents’ perception of high severity for child’s health status was also associated with the appropriateness of ED use. ACKThis study was funded by the Belgian Ministry of Public HealthPASSstudy group Poster : Nathalie da Costa Maya, CDCS NGO , Brussels, October 2011. Table 1:Relationship of explanatory variables with the inappropriateness of A&E Children age less than 2 year Having a family doctor Parent’s perception of high severity for child’s illnessLocalization in Flanders regionComment: After adjustment, the insurance status has no more impact on the appropriateness of A&E use