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  1. Nonurgent use of the pediatric emergency department during the day.

    Article - En anglais

    Objective 

    To evaluate the pattern and reasons for nonurgent use of the pediatric emergency department (PED) during regular office hours and why primary care physicians (PCP) approve such visits.

    Design 

    Prospective, cross-sectional, observational study.

    Setting 

    Free-standing, university-affiliated children's hospital emergency department.

    Patients 

    Patients presenting to the PED and triaged as nonurgent between June and November 1994, Monday through Friday from 6 : 30 am to 6 : 30 pm, and Saturday 6 : 30 am to 12 : 00 noon.

    Measurements 

    Registration and triage information and all communication with the PCP.

    Results 

    Of 1020 eligible patients, 364 patients and their PCP completed the study.

    Fifty-two percent of the study patients were enrolled in a health maintenance organization (HMO).

    This is consistent with the penetration of managed care in this community.

    Most HMO (118 of 191,62%) and non-HMO enrollees (147 of 173,86%) did not call their PCP prior to arrival in the PED.

    Comparing the reasons given by these patients (HMO enrollees versus non-HMO) for not calling, we found : convenience (HMO 17% vs non-HMO 4%, P<0.01), « no identified PCP » (HMO 17% vs non-HMO 42%, P<0.01), and « felt problem was an emergency » (HMO 19% vs non-HMO 10%, P=0.03) to be important differences.

    HMO enrollees received approval for the visit 79% of the time.

    These approvals were mostly after noon, whereas most denials occurred before noon.

    We found a pattern in the reason for approvals. (...)

    Mots-clés Pascal : Service urgence, Pédiatrie, Jour, Utilisation, Service santé, Médecin généraliste, Assurance maladie, Relation médecin malade, Homme, Non urgence, Motif

    Mots-clés Pascal anglais : Emergency department, Pediatrics, Day, Use, Health service, General practitioner, Health insurance, Physician patient relation, Human

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 98-0154744

    Code Inist : 002B30A05. Création : 21/07/1998.