Are Increasing Volumes of Children and Young People Presenting to Emergency Departments Due to Increasing Severity of Illness?

Abstract

BackgroundIncreasing utilization of emergency and acute care services by children and young people is a worldwide trend. This is thought to be a result of parent and carer desire for more “on‐demand” healthcare assessment and not a consequence of increasing severity of disease. A bespoke acuity assessment system in our department allowed us to test this hypothesis.MethodsThese data are based on the Paediatric Observation Priority Score, a previously published and validated assessment tool designed specifically for pediatric emergency care.1 It is scored from 0 to 16 and consists of physiologic, observational, and historical components with a unique “gut feeling” element. Data were available from November 2014 to March 2016.ResultsThere has been a 32.6% increase in the number of children with a POPS > 4 (Figure 1, total number of children with POPS 0, 1–4, and >4) with a small (nonsignificant) increase in relative acuity.ConclusionIn light of the overall total increase in attendances and relative increase in acuity it appears the general cohort of children presenting are more unwell. Given that a POPS > 4 is associated with an increased risk of admission for more than 24 hours2 it can also be concluded that a significant proportion of attendances to the department are appropriate.Total number of children with POPS 0,1‐4 and >4.image