Determinants of use of a paediatric emergency department

Abstract

The purpose of this study was to establish the determinants that influence a patient's choice in seeking medical care in an emergency department. The study was conducted at the Janeway Child Health Centre, St. John's, Newfoundland, in order to study paediatrics, specifically. -- Data was collected from a random sampling of users over a period of six weeks. This yielded a 13 percent sample, all of whom were interrogated by trained interviewers during the study period. -- Various hypotheses were tested by a questionnaire. This instrument was of a form similar to that utilised by others but modified slightly to accommodate special paediatric characteristics. -- Findings indicated that a high percentage (58.1%) of users of the emergency department could be categorised as "non-urgent" by medical classifiers. This proved to be similar to the findings of others in different Provinces, and in other countries. -- Many of the reasons for non-urgent usage of emergency departments put forward by others and incorporated into the questionnaire were not validated by this study. However, this study concludes that a high percentage of users are referred to the emergency department by the private physician or asked to return by an emergency department physician at a later date. -- The study also indicates that patterns of usage of this emergency department are changing and public demands on the facility for non-urgent use will probably increase. Inherent in the reported responses are factors which could be influenced by the hospital, by education of the public, or by regulation which could modify the demand if so desired.