Yoffe Stuart J, Moore Robert W, Gibson John O, Dadfar Nemat M, McKay Rebecca L, McClellan David A, Huang Tse-Yang
Innovative Health Care, Brenham, TX 77833, USA.
Fam Med. 2011 Feb;43(2):106-11.
A substantial proportion of emergency department (ED) visits by children are for non-urgent care. The objective of this research is to determine whether a parent-focused educational intervention can reduce non-urgent ED visits.
A regional hospital system (which includes a central hospital, four satellite hospitals, and two primary care clinics) provided monthly data retrospectively from January 2006 to October 2007 on ED visits by children. The same information was provided prospectively from November 2007 to April 2009. Starting in November 2007, a family medicine residency program affiliated with the same hospital network distributed a 6.7 grade reading level booklet on non-urgent care of children to the parents who brought their children to the outpatient clinic. The number of ED visits as a proportion of outpatient clinic visits at the residency program was calculated for each month and compared to historical and geographic trends.
Long-term changes were observed only among the intervention group. There was a substantial and statistically significant reduction in ED use for non-urgent care of children. There was also a proportional reduction in ED charges for this group.
An educational intervention among parents can substantially reduce non-urgent ED visits for their children.
儿童前往急诊科(ED)就诊的很大一部分是为了非紧急护理。本研究的目的是确定以家长为重点的教育干预措施是否能减少非紧急的ED就诊。
一个区域医院系统(包括一家中心医院、四家卫星医院和两家初级保健诊所)回顾性地提供了2006年1月至2007年10月期间儿童ED就诊的月度数据。2007年11月至2009年4月期间前瞻性地提供了相同信息。从2007年11月开始,隶属于同一医院网络的一个家庭医学住院医师项目向带孩子到门诊就诊的家长发放了一本针对儿童非紧急护理的6.7年级阅读水平的手册。计算住院医师项目中每个月ED就诊次数占门诊就诊次数的比例,并与历史和地理趋势进行比较。
仅在干预组中观察到长期变化。儿童非紧急护理的ED使用量有大幅且具有统计学意义的减少。该组的ED费用也相应减少。
对家长进行教育干预可以大幅减少其子女的非紧急ED就诊。