Elizabeth R. Alpern|Amy Clark|Evaline A. Alessandrini|Marc H. Gorelick|Marlena Kittick|Rachel Stanley|Jonathan Dean|Stephen J. Teach|James M. Chamberlain
Recurrent and High-frequency Use of the Emergency Department by Pediatric Patients
Northwestern University|Lurie Children's Hospital|University of Utah|Cincinnati Children's Hospital Medical Center|University of Cincinnati|Children's Hospital of Wisconsin|Medical College of Wisconsin|Children's Hospital of Philadelphia|University of Michigan–Ann Arbor|University of Utah|Children's National|Children's National
authors sought describe epidemiology risk factors recurrent highfrequency use emergency department ed childrenthis retrospective cohort study using database children aged 0 17 years inclusive presenting 22 eds pediatric emergency care applied research network pecarn 2007 12month followup index visit ed diagnoses visit categorized trauma acute medical chronic medical conditions recurrent visits defined repeat visit highfrequency use defined four recurrent visits generalized estimating equations gees used measure strength associations patient visit characteristics recurrent ed usea total 695188 unique children least one ed visit 2007 455588 recurrent ed visits 12 months following index visits sixtyfour percent patients recurrent visits 20 one 8 two 4 three 4 four recurrent visits acute medical diagnoses accounted visits regardless number recurrent visits number recurrent visits per patient rose chronic diseases increasingly represented asthma common ed diagnosis traumarelated diagnoses common among patients without recurrent visits among highfrequency recurrent visits 28 vs 9 p0001 highfrequency recurrent visits often within highest severity score classifications multivariable analysis recurrent visits associated younger age black hispanic race ethnicity public health insurancerisk factors recurrent ed use children include age race ethnicity insurance status although asthma plays important role recurrent ed use acute illnesses account majority recurrent ed visits