Berry Anne, Brousseau David, Brotanek Jane M, Tomany-Korman Sandra, Flores Glenn
Pennsylvania State College of Medicine, Hershey, PA, USA.
Ambul Pediatr. 2008 Nov-Dec;8(6):360-7. doi: 10.1016/j.ambp.2008.07.001. Epub 2008 Oct 5.
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.
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.
For the 31 families interviewed, the mean parental age was 28 years, and mean child age, 3 years. Reasons cited by caregivers 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.
Parents bring their children to the ED for nonurgent 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.
非紧急情况占儿科急诊科就诊病例的58%至82%，但仅有一项初步定性研究探讨了家长带孩子到急诊科接受非紧急治疗的原因。本研究的目的是确定家长在非紧急儿科护理中选择急诊科而非初级保健提供者（PCP）的原因。
在4周时间内，于工作日上午8点至下午4点，在一家儿童医院急诊科对前来接受非紧急治疗的儿童家长进行了英语和西班牙语的录音人种学访谈。
在接受访谈的31个家庭中，家长的平均年龄为28岁，孩子的平均年龄为3岁。照顾者选择急诊科而非孩子的初级保健提供者的原因包括预约等待时间长、对初级保健提供者不满意、沟通问题（口音和初级保健提供者处无用的工作人员）、医疗服务提供者转诊、效率、急诊科资源、便利性、护理质量以及急诊科对儿童的专业知识。一些家长表示希望接受有关儿科问题紧急程度的教育。
家长因初级保健提供者的问题、初级保健提供者的转诊以及对急诊科护理的感知优势，而带孩子到急诊科接受非紧急护理。尽管家长报告说有关儿科疾病紧急程度的教育会有所帮助，但要大幅减少儿科非紧急情况下的急诊科就诊，可能需要改善家庭获得初级保健提供者服务的机会、效率、体验以及预约安排。
