From the Division of Emergency Medicine, Children's National Health System.
Pediatr Emerg Care. 2022 Jan 1;38(1):e417-e421. doi: 10.1097/PEC.0000000000002312.
Pediatric patients account for a disproportionate number of low-acuity emergency department (ED) visits. The aim of this study is to describe pediatric patient and visit characteristics for high-frequency users for low-acuity visits.
This was a retrospective cohort study of children presenting to a tertiary care pediatric ED and an affiliated community ED, over a 2-year period, with at least 10 low-acuity visits. Twenty patients with the highest number of visits were classified as "superusers." We analyzed patient data from the larger sample of high-frequency users and visit specific data from superuser visits. IBM SPSS Statistics 25 (SPSS Inc., Chicago, IL) was used to perform descriptive statistics and to summarize demographic and visit specific variables.
We identified 181 high-frequency users with a mean number of visits of 14.3 ± 4.3 and a subpopulation of 20 superusers accounting for 434 visits. The majority of high-frequency users (89%) identified as African American and had public insurance (96.1%). Many patients received primary care affiliated with the home institution. In the first year of the study, 50.3% of high-frequency users were infants younger than 1 year at the index visit and 47.4% of superusers were infants at the index visit.Superuser visits were evenly distributed among seasons and the majority of visits occurred during the weekdays (70.7%). The majority of visits were for medical complaints (86.6%) and almost half (47.6%) resulted in some testing (24.9%) or treatment (30.6%); however, only 1.4% resulted in hospital admission.
In our sample, most high-frequency low-acuity ED patients were infants, African American and have public insurance. Many are seen during clinic hours and are paneled at affiliated clinics. Among superusers, the majority of the visits did not require any testing, intervention, or treatment.
儿科患者在低 acuity 急诊科（ED）就诊中占不成比例的数量。本研究的目的是描述高频低 acuity 就诊患儿患者和就诊特征。
这是一项回顾性队列研究，纳入了在两年期间至少有 10 次低 acuity 就诊的三级儿童 ED 和附属社区 ED 的儿科患者。将就诊次数最多的 20 名患者归类为“超级用户”。我们分析了较大高频就诊患者人群的数据以及超级用户就诊的具体就诊数据。使用 IBM SPSS Statistics 25（SPSS Inc.，芝加哥，IL）进行描述性统计分析和总结人口统计学和就诊特征变量。
我们确定了 181 名高频就诊患者，平均就诊次数为 14.3 ± 4.3 次，其中 20 名超级用户的就诊次数为 434 次。大多数高频就诊患者（89%）为非裔美国人，且有公共保险（96.1%）。许多患者在附属医疗机构接受初级保健。在研究的第一年，50.3%的高频就诊患者在就诊时为 1 岁以下的婴儿，47.4%的超级用户在就诊时为婴儿。超级用户就诊在各个季节分布均匀，且大多数就诊发生在工作日（70.7%）。就诊的主要原因是医疗投诉（86.6%），几乎一半（47.6%）需要进行一些检查（24.9%）或治疗（30.6%）；然而，只有 1.4%的患者需要住院治疗。
在我们的样本中，大多数高频低 acuity ED 患者为婴儿、非裔美国人，且有公共保险。许多患者在就诊时间内就诊，且在附属诊所就诊。在超级用户中，大多数就诊不需要任何检查、干预或治疗。
