The changing utilization of a children’s emergency department

Abstract

ABSTRACT Objective To assess the changing pattern of attendance at an emergency department in a children’s hospital. Design A retrospective review of the attendance register from 1 September 1986 to 31 August 1998. Setting Derbyshire Children’s Hospital, Derby, serving a mixed urban and rural population within the National Health Service. Measurement Total number of attendances and admissions each year. For one week in February and August each year: age and case mix assessed. For the period 1994–98: the source of the referral and the outcome of patients referred by their General Practitioner (GP). Results Over the study period: a rise in attendances from 4853 to 8796; no change in the total number admitted to hospital. A decline in the proportion admitted from 56 to 32%. For the period 1994–98: no change in the number of patients referred by their GP; an increasing number of self‐referrals. Overall age mix: age < 1 year, 27%; age 1–4 years, 42%; age 5–12 years, 26%; age > 13 years, 5%. Overall case mix: medical, 73%; surgical, 9%; trauma/minor injuries, 18%. Conclusion An important change has occurred in the utilization of our paediatric emergency department with increasing numbers of children seeking hospital assessment, largely via self‐referrals, but not requiring hospital admission. Implications for practice Future planning and deployment of paediatric resources need to take account of the change in use of hospital emergency services.