Emergency pediatrics: About 3% of child patients make more than 10% of visits to hospital units, first-of-its-kind study says

A new study by a team including Texas A&M University School of Public Health researchers found that about 3% of pediatric patients who seek treatment at hospital emergency departments (EDs) account for more than 10% of all ED visits. 

The study was conducted by Dr. Benjamin Ukert, assistant professor in the department of Health Policy and Management, and Dr. Hye-Chung Kum, director of the Population Informatics Lab, along with four other colleagues. The study was published in the journal Academic Pediatrics. 

The finding was part of the first known study of the diverse factors behind two different uses of EDs by children and young adults—visits caused by health issues that are chronic and persistent, and those that are temporary and frequent. 

“Children account for about 20 percent of all ED visits in the United States,” Ukert said. “But these visits are not distributed uniformly across that age group. We wanted to follow children who were without a history of ED visits to find out if they became pediatric frequent ED users over a period of years.” 

The researchers assessed 1.3 million pediatric ED users using ED data provided by the Healthcare Cost and Utilization Project, the nation’s most comprehensive hospital care database. 

The study found that frequent ED users had higher intensity of chronic conditions and comorbidities, were more likely to have inconsistent health insurance coverage over time, to live in non-metropolitan or lower-income areas, and to have more ED visits for conditions that were preventable or could be treated by non-emergency care. 

In addition, more than half of the ED visits by frequent patients were for less urgent conditions. While these patients could be better served in outpatient situations, obstacles such as difficulty finding physicians and setting appointments, lack of transportation and language barriers make outpatient care unlikely for about one-third of children in the United States. 

Overall, the findings suggest that health care outcomes could be improved, and the cost of ED visits lowered if hospital systems, clinicians and policymakers recognized the very different types and durations of health issues when designing and implementing health interventions.