Characteristics of frequently attending children in hospital emergency departments: a systematic review
Abstract
OBJECTIVE: To summarise the literature on frequent attendances to hospital emergency departments (EDs) and describe sociodemographic and clinical characteristics of children who attend EDs frequently.
SETTING: Hospital EDs.
PARTICIPANTS: Children <21 years, attending hospital EDs frequently.
PRIMARY OUTCOME MEASURES: Outcomes measures were defined separately in each study, and were predominantly the number of ED attendances per year.
RESULTS: We included 21 studies representing 6 513 627 children. Between 0.3% and 75% of all paediatric ED users were frequent users. Most studies defined four or more visits per year as a 'frequent ED' usage. Children who were frequent ED users were more likely to be less than 5 years old. In the USA, patients with public insurance were more likely to be frequent attenders. Frequent ED users more likely to be frequent users of primary care and have long-term conditions; the most common diagnoses were infections and gastroenteritis.
CONCLUSIONS: The review included a wide range of information across various health systems, however, children who were frequent ED users have some universal characteristics in common. Policies to reduce frequent attendance might usefully focus on preschool children and supporting primary care in responding to primary care oriented conditions.
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 6 participants or records.
Read the paper
Related studies
- Patient-Centered Pharmaceutical Design to Improve Acceptability of Medicines: Similarities and Differences in Paediatric and Geriatric Populations
- Evidence-based clinical practice guidelines for irritable bowel syndrome 2020
- Phase 2b Study of Pimodivir (JNJ-63623872) as Monotherapy or in Combination With Oseltamivir for Treatment of Acute Uncomplicated Seasonal Influenza A: TOPAZ Trial
- Gastrointestinal manifestations in COVID-19
- COVID-19 and Gastrointestinal Disease: Implications for the Gastroenterologist
- Persistent gut barrier damage and commensal bacterial influx following eradication of Giardia infection in mice
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.