Journal
AMBULATORY PEDIATRICS
Volume 8, Issue 6, Pages 360-367Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.ambp.2008.07.001
Keywords
nonurgent; pediatric emergency department; underserved populations
Categories
Funding
- APS/SPR Summer Student Research Program [HID 007446]
- Robert Wood Johnson Physician Faculty Scholars Program
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Objective.-Nonurgent conditions account for 58% to 82% of pediatric emergency department (ED) visits, but only 1 preliminary qualitative study has examined reasons why parents bring children to the ED for nonurgent care. The aim of this study was to identify parents' reasons for choosing the ED over their primary care provider (PCP) for nonurgent pediatric care. Methods.-Audiotaped ethnographic interviews in English and Spanish were conducted of parents of children presenting for nonurgent care on weekdays from 8 AM to 4 PM at a children's hospital ED over a 4-week period. Results.-For the 31 families interviewed, the mean parental age was 28 years, and mean child age, 3 years. Reasons cited by care-givers for choosing the ED over their child's PCP were long appointment waits, dissatisfaction with the PCP. communication problems (accents and unhelpful staff at PCP), health care provider referral, efficiency, ED resources, convenience, quality of care, and ED expertise with children. Some parents said they would like education on the urgency of pediatric problems. Conclusions.-Parents bring their children to the ED for nonuraent care because of problems with their PCP, PCP referral, and perceived advantages to ED care. Although parents report that education on the urgency of pediatric conditions would be helpful, substantial reduction of pediatric nonurgent ED use may require improvements in families' PCP office access, efficiency, experiences, and appointment scheduling.
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