Abstract
The purpose of this study was to empirically evaluate if children from low socio-economic status (SES) families in regional southeast Queensland utilise acute care services for low acuity health care rather than utilising primary health services. A retrospective audit of children under the age of 5 years presented at a regional hospital emergency department (ED) over a 12-month period. Medical records were examined for presenting problem, Australasian triage category, care outcomes, whether the child's parent/guardian held an Australian concession/health care card (AC/HCC) and accessed child health services or a general medical practitioner (GP). Eight hundred and eighty-eight children who had not reached their fifth birthday presented to ED between 1 June 2019 and 31 May 2020, with a total of 1691 presentations. Most children were bought to the ED by their parents with semi-urgent health concerns and were discharged home following medical review. Holding an AC/HCC was a significant predictor for hospital presentation. Holding an AC/HCC was not associated with access to child health services. However, accessing child health services resulted in a small but significant increase in hospital presentations. The AC/HCC may be an important proxy to identify low SES individuals. These card holders tended to use acute services more frequently than those who did not qualify for an AC/HCC. Furthermore, families that engage with primary care services such as child health also accessed acute care services more frequently. The results indicate accessing primary health-care services does not ameliorate the use of acute care services.
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