Self-referral and serious illness in children with fever
| Autor: | Rianne Oostenbrink, Nienke Seiger, Henriëtte A. Moll, Mirjam van Veen, Yvette van Ierland, Alfred H J van Meurs, Madelon Ruige |
|---|---|
| Přispěvatelé: | Pediatrics |
| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Pediatrics Adolescent Fever Cross-sectional study Decision Making General Practice Psychological intervention Sensitivity and Specificity Severity of Illness Index Hospitals University Diagnostic Self Evaluation Severity of illness medicine Emergency medical services Confidence Intervals Odds Ratio Humans Parent-Child Relations Child Referral and Consultation Netherlands Self Referral business.industry Infant Emergency department Odds ratio Triage Cross-Sectional Studies Child Preschool Pediatrics Perinatology and Child Health Emergency medicine Female business Emergency Service Hospital |
| Zdroj: | Pediatrics, 129(3), e643-e651. American Academy of Pediatrics |
| ISSN: | 1098-4275 0031-4005 |
| Popis: | OBJECTIVE: The goal of this study was to evaluate parents’ capability to assess their febrile child’s severity of illness and decision to present to the emergency department. We compared children referred by a general practitioner (GP) with those self-referred on the basis of illness-severity markers. METHODS: This was a cross-sectional observational study conducted at the emergency departments of a university and a teaching hospital. GP-referred or self-referred children with fever (aged RESULTS: Thirty-eight percent of 4609 children were referred by their GP and 62% were self-referred. GP-referred children were classified as high urgency (immediate/very urgent categories) in 46% of the cases and self-referrals in 45%. Forty-three percent of GP referrals versus 27% of self-referrals needed extensive diagnostic intervention, intravenous medication/aerosol treatment, hospitalization, or a combination of these (odds ratio: 2.0 [95% confidence interval: 1.75–2.27]). In all subgroups, high urgency was not associated with referral type. GP-referred and self-referred children with dyspnea had similar frequencies of illness-severity markers. CONCLUSIONS: Although febrile self-referred children were less severely ill than GP-referred children, many parents properly judged and acted on the severity of their child’s illness. To avoid delayed or missed diagnoses, recommendations regarding interventions that would discourage self-referral to the emergency department should be reconsidered. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|