Rivas García Arístides, Manrique Martín Gema, Butragueño Laiseca Laura, Mesa García Sofía, Campos Segura Alfonso, Fernández Iglesia Vanessa, Moreno Sánchez Rubén, Aguilar Mulet Juan Mariano
Hospital Universitario Gregorio Marañón, Madrid, España.
Hospital Universitario Gregorio Marañón, Madrid, España.
An Pediatr (Barc). 2017 Feb;86(2):67-75. doi: 10.1016/j.anpedi.2016.03.008. Epub 2016 Apr 16.
To determine the prevalence of frequent Paediatric Emergency Departments users and to analyse their characteristics, comparing initial consultations and re-consultations.
This is a multicentre retrospective cohort study of all patients who made 10 or more visits to the Paediatric Emergency Departments of 5 public hospitals between 1 January 2013 and 31 December 2013. An analysis was performed on the patient demographics and clinical data of the first consultation and consecutive re-consultations.
Frequent users represented 0.60% (95% CI: 0.56-0.64%) of Emergency Department users, and accounted for 3.93% (95% CI: 3.47-4.39%) of all visits. The most numerous age group consisted of children under 2 years old (66.6%). Frequent users distributed their visits throughout the year (62.3%; P<.001), and did not have a chronic condition associated with their chief complaint (86.4%; P<.001). They were usually classified as non-urgent or less urgent in triage (3,186 vs. 1,812; P<.001), and often did not require any intervention, such as complementary tests (79.4%) or observation/treatment (60%). Admission rate was similar to the general paediatric population (5.3%). Re-consultations represented 27% of these patient visits, mostly related to persistence of symptoms (56.3%), with 13.8% of them consulting their Primary Care physician before seeking successive medical attention in the Paediatric Emergency Department.
Paediatric frequent users often ask for medical care in the Emergency Department before consulting their Primary Care physician. They present with less urgent processes and do not systematically need diagnostic or therapeutic interventions. Re-consultations make up a significant number of visits, in which more interventions are done and more children are admitted.
确定儿科急诊科频繁就诊者的患病率，并分析其特征，比较初次就诊和再次就诊情况。
这是一项多中心回顾性队列研究，研究对象为2013年1月1日至2013年12月31日期间在5家公立医院儿科急诊科就诊10次及以上的所有患者。对初次就诊及连续再次就诊的患者人口统计学和临床数据进行了分析。
频繁就诊者占急诊科就诊者的0.60%（95%可信区间：0.56 - 0.64%），占所有就诊次数的3.93%（95%可信区间：3.47 - 4.39%）。人数最多的年龄组为2岁以下儿童（66.6%）。频繁就诊者全年均有就诊（62.3%；P<0.001），且主诉无相关慢性病（86.4%；P<0.001）。他们在分诊时通常被归类为非紧急或低紧急情况（3186例对1812例；P<0.001），且通常不需要任何干预，如辅助检查（79.4%）或观察/治疗（60%）。住院率与普通儿科人群相似（5.3%）。再次就诊占这些患者就诊次数的27%，主要与症状持续有关（56.3%），其中13.8%的患者在到儿科急诊科寻求后续医疗护理之前咨询过初级保健医生。
儿科频繁就诊者常在咨询初级保健医生之前就到急诊科寻求医疗护理。他们就诊的病情紧急程度较低，且并非都需要诊断或治疗干预。再次就诊占就诊次数的很大一部分，其中进行了更多干预，且更多儿童住院。
