Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK.
Emerg Med J. 2021 Feb;38(2):146-150. doi: 10.1136/emermed-2019-209122. Epub 2020 Nov 16.
Frequent attendances of the same users in emergency departments (ED) can intensify workload pressures and are common among children, yet little is known about the characteristics of paediatric frequent users in EDs.
To describe the volume of frequent paediatric attendance in England and the demographics of frequent paediatric ED users in English hospitals.
We analysed the Hospital Episode Statistics dataset for April 2014-March 2017. The study included 2 308 816 children under 16 years old who attended an ED at least once. Children who attended four times or more in 2015/2016 were classified as frequent users. The preceding and subsequent years were used to capture attendances bordering with the current year. We used a mixed effects logistic regression with a random intercept to predict the odds of being a frequent user in children from different sociodemographic groups.
One in 11 children (9.1%) who attended an ED attended four times or more in a year. Infants had a greater likelihood of being a frequent attender (OR 3.24, 95% CI 3.19 to 3.30 vs 5 to 9 years old). Children from more deprived areas had a greater likelihood of being a frequent attender (OR 1.57, 95% CI 1.54 to 1.59 vs least deprived). Boys had a slightly greater likelihood than girls (OR 1.05, 95% CI 1.04 to 1.06). Children of Asian and mixed ethnic groups were more likely to be frequent users than those from white ethnic groups, while children from black and 'other' had a lower likelihood (OR 1.03, 95% CI 1.01 to 1.05; OR 1.04, 95% CI 1.01 to 1.06; OR 0.88, 95% CI 0.86 to 0.90; OR 0.90, 95% CI 0.87 to 0.92, respectively).
One in 11 children was a frequent attender. Interventions for reducing paediatric frequent attendance need to target infants and families living in deprived areas.
同一患者在急诊科（ED）的频繁就诊会增加工作量压力，这在儿童中很常见，但对于 ED 中儿科高频就诊者的特征知之甚少。
描述英国儿科高频就诊的数量以及英国医院儿科高频 ED 就诊者的人口统计学特征。
我们分析了 2014 年 4 月至 2017 年 3 月的医院入院统计数据。研究纳入了至少在 ED 就诊一次的 2308816 名 16 岁以下儿童。2015/2016 年就诊 4 次或以上的患儿被归类为高频就诊者。前一年和后一年用于捕获当年就诊的边界就诊次数。我们使用具有随机截距的混合效应逻辑回归来预测不同社会人口统计学组患儿成为高频就诊者的几率。
每 11 名就诊 ED 的患儿中就有 1 名（9.1%）在一年内就诊 4 次或以上。婴儿更有可能成为高频就诊者（OR 3.24，95%CI 3.19 至 3.30 与 5 至 9 岁相比）。来自贫困地区的儿童更有可能成为高频就诊者（OR 1.57，95%CI 1.54 至 1.59 与最不贫困地区相比）。男孩成为高频就诊者的可能性略高于女孩（OR 1.05，95%CI 1.04 至 1.06）。与白人种族群体相比，亚洲和混合种族群体的儿童更有可能成为高频就诊者，而黑人儿童和“其他”种族儿童的可能性较低（OR 1.03，95%CI 1.01 至 1.05；OR 1.04，95%CI 1.01 至 1.06；OR 0.88，95%CI 0.86 至 0.90；OR 0.90，95%CI 0.87 至 0.92）。
每 11 名儿童中就有 1 名是高频就诊者。减少儿科高频就诊的干预措施需要针对婴儿和生活在贫困地区的家庭。
