Advice seeking and appropriate use of a pediatric emergency department

Am J Dis Child. 1993 Aug;147(8):863-7. doi: 10.1001/archpedi.1993.02160320065021.


Objectives: To determine whether seeking advice prior to an unscheduled visit to a pediatric emergency department (PED) influences appropriate use of this setting for minor illnesses.

Design: Cross-sectional questionnaire survey.

Setting: The medical emergency department of the Montreal (Quebec) Children's Hospital, a major referral and urban teaching hospital.

Participants: Four hundred eighty-nine of 562 consecutive parents visiting the PED over two periods, one in February and the other in July 1989.

Interventions: None.

Measurements/main results: Parents of children between 0 and 18 years of age visiting the PED were asked whether they had previously sought advice from family, friends, or a physician. Other factors possibly related to the decision to seek care were also measured. Appropriateness was rated, blind to discharge diagnosis, by two pediatricians using a structured series of questions incorporating the child's age, time of the visit, clinical state, and problem at presentation. Thirty-four percent of visits among respondents were judged appropriate. In bivariate analysis, appropriate visits occurred significantly more often when a parent spoke to both a physician and a nonphysician (47%) prior to visiting the PED than when no advice was sought (29%; P < .05). In multivariate analysis, having a regular physician and being one of two children also contributed to appropriateness.

Conclusions: Appropriate use of the PED was positively influenced by seeking prior advice from both a physician and family member, having a regular physician, and having prior child care experience.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Age Factors
  • Algorithms
  • Birth Order
  • Child
  • Child, Preschool
  • Counseling / statistics & numerical data*
  • Cross-Sectional Studies
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • Health Services Misuse / statistics & numerical data*
  • Health Services Research
  • Hospitals, Pediatric / statistics & numerical data
  • Hospitals, Teaching / statistics & numerical data
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Parents / education
  • Parents / psychology
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Quebec
  • Severity of Illness Index
  • Sex Factors
  • Surveys and Questionnaires