Stockwell Melissa S, Rausch John, Sonnett Meridith, Stanberry Lawrence R, Rosenthal Susan L
Division of General Pediatrics, Department of Pediatrics, College of Physicians and Surgeons, Columbia University, 622 W 168th St, VC 402, New York, NY 10032, USA.
Pediatr Emerg Care. 2011 Apr;27(4):261-5. doi: 10.1097/PEC.0b013e3182131420.
The objective of the study was to understand the utilization of the pediatric emergency department (PED) of an academic hospital during regular primary care office hours during the 2009 H1N1 epidemic. Children with a usual source of care presenting for influenza-like illness (ILI) symptoms were compared with those presenting with other symptoms.
During the 2009 H1N1 outbreak, parents visiting a PED in a low-income area in New York City in June 2009 were surveyed using open- and close-ended questions. Sociodemographic factors and reasons for seeking care in the PED rather than their usual source of care were compared between groups.
There were no sociodemographic differences among children brought to the PED for ILI and those brought for other presenting symptoms. Those families with a child with ILI symptoms were less likely to report urgency as the primary reason they brought their child to the PED. A common reason reported for coming to the PED was limited access to care. In further exploration of limited access, parents with a child with ILI symptoms were more likely to report that their usual source of care did not have any evening and/or weekend hours, and they did not know how to reach their provider after hours.
Enhancing access to primary care settings and encouraging parents to use their primary care providers might reduce the utilization of the PED for nonurgent problems during epidemics.
本研究的目的是了解2009年甲型H1N1流感疫情期间，一所学术医院儿科急诊科（PED）在常规初级保健门诊时间的使用情况。将出现流感样疾病（ILI）症状且有常规医疗来源的儿童与出现其他症状的儿童进行比较。
在2009年甲型H1N1流感爆发期间，2009年6月对纽约市低收入地区一家儿科急诊科的就诊家长进行了开放式和封闭式问题调查。比较了两组之间的社会人口统计学因素以及在儿科急诊科而非其常规医疗来源寻求治疗的原因。
因ILI被带到儿科急诊科的儿童与因其他症状被带到儿科急诊科的儿童在社会人口统计学方面没有差异。那些孩子有ILI症状的家庭不太可能将紧急情况作为带孩子去儿科急诊科的主要原因。报告前往儿科急诊科的一个常见原因是获得医疗服务的机会有限。在进一步探讨获得医疗服务机会有限的问题时，孩子有ILI症状的家长更有可能报告说他们的常规医疗来源没有任何夜间和/或周末服务时间，而且他们不知道下班后如何联系他们的医疗服务提供者。
增加初级保健机构的可及性并鼓励家长使用他们的初级保健提供者，可能会减少疫情期间儿科急诊科因非紧急问题的使用情况。
