Furia Giuseppe, Ingravalle Fabio, Vinci Antonio, Papini Paolo, Barbara Andrea, Chierchini Patrizia, Damiani Gianfranco, Maurici Massimo, De Vito Corrado
Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy.
Local Health Authority Roma 1, Borgo Santo Spirito, 00193 Rome, Italy.
Epidemiologia (Basel). 2025 Jun 21;6(3):31. doi: 10.3390/epidemiologia6030031.
: Inappropriate use of emergency department (ED) services is widely acknowledged to have a negative impact on health systems as a whole. A minor portion of Frequent User (FU) patients are often responsible for the disproportionate use of ED services. : A retrospective population study was conducted on the attendances of pediatric EDs from 1 January 2022 to 31 December 2022 at the Roma 1 Local Health Authority in Rome, a territory served by more than 13 EDs. Nested logistic regression analysis was used to investigate patient characteristics in predicting inappropriate use of EDs. : In 2022, 35,691 pediatric ED attendances were recorded, with 24,824 patients distributed among 904 PCP/GPs in the six districts. A total of 71.8% of patients had only one attendance in 2022. A total of 3.5% of the patients were FUs, who were responsible for more than 10% of the attendances. However, most of the attendances were not appropriate. FUs, younger age (<2 yo), and more severe clinical presentations were more likely to be associated with appropriate ED attendance. PCPs/GPs and districts do not have a role in determining a higher number of ED attendances. The single patient's characteristics have a greater influence on this phenomenon. : Frequent use of the ED is not associated with inappropriate use among children, mainly due to the characteristics and needs of specific patients. However, parents' education for a more rational use of health system resources and the provision of local solutions to children's health needs may allow for a more appropriate use of health service resources.
急诊科（ED）服务的不当使用被广泛认为会对整个卫生系统产生负面影响。一小部分频繁使用者（FU）患者往往是导致急诊科服务使用不成比例的原因。
对罗马第一地方卫生当局辖区内2022年1月1日至2022年12月31日期间儿科急诊科的就诊情况进行了一项回顾性人群研究，该辖区由13个以上的急诊科提供服务。采用嵌套逻辑回归分析来研究预测急诊科不当使用的患者特征。
2022年，记录了35691例儿科急诊科就诊病例，24824名患者分布在六个区的904名初级保健医生/全科医生处。2022年，共有71.8%的患者仅就诊一次。共有3.5%的患者为频繁使用者，他们的就诊次数占总就诊次数的10%以上。然而，大多数就诊并不恰当。频繁使用者、年龄较小（<2岁）以及临床表现更严重的患者更有可能与恰当的急诊科就诊相关。初级保健医生/全科医生和地区在决定更多的急诊科就诊次数方面没有作用。单个患者的特征对这一现象有更大影响。
儿童频繁使用急诊科与不当使用无关，主要是由于特定患者的特征和需求。然而，对家长进行关于更合理使用卫生系统资源的教育以及提供针对儿童健康需求的当地解决方案，可能会使卫生服务资源得到更恰当的使用。
