Parents and primary care physicians are satisfied with children's use of nonurgent emergency department services
Nonurgent emergency department (ED) use is considered a problem because of the higher cost to society and the loss of continuity of care. However, a new study found that both parents and primary care physicians (PCPs) generally considered these visits appropriate. Also, neither parents nor physicians saw these visits as a significant enough breach of continuity of care to warrant concern. The researchers interviewed 26 parents of children who had received nonurgent emergency care and 20 of their PCPs.
The interviews also revealed that the need for immediate reassurance that their children are safe from harm is critical to parents' decisions; PCP offices lack specific tests and treatments that parents and physicians believe may be necessary, regardless of whether they are actually needed; and discrepancies exist between PCP and parent perceptions of adequate communication and care access.
The children seen in an academic pediatric ED were treated for fever, pain (oral, ear), breathing problems (wheezing, coughing), rash, laceration, bump on the head, nosebleed, minor trauma, and swollen eye. Parents in this study did not express significant concern about costs. Either they did not have to pay, or they believed the quality of care justified higher charges. The researchers concluded that nonurgent ED use serves as an effective care resource for families, and parents have little motivation to change their current care-seeking behaviors. This study was supported by the Agency for Healthcare Research and Quality (HS15482).
See "Nonurgent emergency-department care: Analysis of parent and primary physician perspectives," by David C. Brousseau, M.D., Mark R. Nimmer, B.A., Nichole L. Yunk, M.S., and others in the February 2011 Pediatrics 127, pp. e375-3381.
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