Parents' perspective on pediatric emergency department visits for low-acuity conditions before and during the COVID-19 pandemic: a cross-sectional bicentric study.

Autor: Samman K; Department of Pediatrics, Centre Hospitalier Régional de Lanaudière, St-Charles-Borromée, QC, Canada., Le CK; Division of Pediatric Emergency Medicine, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montréal, QC, Canada., Burstein B; Division of Pediatric Emergency Medicine, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montréal, QC, Canada.; Department of Biostatistics, Epidemiology and Occupational Health, McGill University, Montréal, QC, Canada., Rehimini S; McGill University, Montréal, QC, Canada., Grenier A; Department of Family Medicine, GMF Nouvelle-Beauce, Sainte-Marie, QC, Canada., Bertrand-Bureau C; Université de Laval, Québec, QC, Canada., Mallet M; Centre de Recherche du CHU de Québec-Université Laval, Québec, QC, Canada., Simonyan D; CHU de Québec-Université Laval, Québec, QC, Canada., Berthelot S; Département de médecine de famille et de médecine d'urgence, Université Laval, Québec, QC, Canada. simon.berthelot@fmed.ulaval.ca.; Centre de recherche du CHU de Québec-Université Laval, Axe Santé des populations et pratiques optimales en santé,, Québec, QC, Canada. simon.berthelot@fmed.ulaval.ca.
Jazyk: angličtina
Zdroj: CJEM [CJEM] 2024 Jan; Vol. 26 (1), pp. 31-39. Date of Electronic Publication: 2023 Nov 30.
DOI: 10.1007/s43678-023-00609-9
Abstrakt: Objectives: The primary objective of this study was to describe and compare the motivation of parents/guardians to bring children with low-acuity conditions to a tertiary-care pediatric emergency department (ED) versus a clinic before and after the pandemic. The secondary objectives were to describe and compare the demographic and clinical characteristics of the population studied and the impact of the pandemic on their access to primary care services.
Methods: This is a cross-sectional study based on a survey administered to parents/guardians of patients presenting with low-acuity conditions at one of two EDs.
Results: The respondents numbered 659. Children were brought to a pediatric ED generally because of the perceived urgency of the condition, the presumed resource availability in the pediatric ED and the unavailability of the primary care physician. However, most respondents (n = 438, 66.5%) indicated preference for a clinic. More respondents before than during the pandemic reported they had been unable to find a doctor outside the ED (48.6% before COVID vs 26.8% during COVID, p < 0.001) but patients during the pandemic were less likely to seek care in a primary care practice or walk-in clinic (30.0% during COVID vs 48.6% before COVID, p < 0.001). In addition, the number of respondents presenting with symptoms of infection decreased by more than half after the pandemic began while the proportion of musculoskeletal and psychiatric complaints doubled.
Conclusion: Although the pandemic has altered the landscape of presenting complaints and pediatric healthcare-seeking behaviors, most respondents indicated they would prefer to receive care in a clinic. This finding contradicts the view that most pediatric ED visits for low-acuity conditions are by choice rather than perceived necessity. Prioritizing improved access to primary care resources would better address the preferences and expectations of parents/guardians.
(© 2023. The Author(s), under exclusive licence to Canadian Association of Emergency Physicians (CAEP)/ Association Canadienne de Médecine d'Urgence (ACMU).)
Databáze: MEDLINE
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