Abstract

Background

Although children with special health care needs (CSHCN) represent a minority of the population, they go through more hospitalizations, more admissions to the Emergency Department (ED), and receive a major number of medical prescriptions, in comparison to general pediatric population. Objectives of the study were to determine the reasons for admission to the ED in Italian CSHCN, and to describe the association between patient’s demographic data, clinical history, and health services requirements.

Methods

Ad hoc web site was created to collect retrospective data of 3479 visits of CSHCN to the ED in 58 Italian Hospitals.

Results

Seventy-two percent of patients admitted to ED were affected by a previously defined medical condition. Most of the ED admissions were children with syndromic conditions (54%). 44.2% of the ED admissions were registered during the night-time and/or at the weekends. The hospitalization rate was of 45.6% among patients admitted to the ED. The most common reason for admission to the ED was the presence of respiratory symptoms (26.6%), followed by gastrointestinal problems (21.3%) and neurological disorders (18.2%). 51.4% of the access were classified as ‘urgent’, with a red/yellow triage code. Considering the type of ED, 61.9% of the visits were conducted at the Pediatric EDs (PedEDs), 33.5% at the Functional EDs (FunEDs) and 4.6% at the Dedicated EDs (DedEDs). Patients with more complex clinical presentation were more likely to be evaluated at the PedEDs. CSHCN underwent to a higher number of medical procedures at the PedEDs, more in comparison to other EDs. Children with medical devices were directed to a PedED quite exclusively when in need for medical attention. Subjects under multiple anti-epileptic drug therapy attended to PedEDs or FunEDs generally. Patients affected by metabolic diseases were more likely to look for medical attention at FunEDs. Syndromic patients mostly required medical attention at the DedEDs.

Conclusions

Access of CSHCN to an ED is not infrequent. For this reason, it is fundamental for pediatricians working in any kind of ED to increase their general knowledge about CHSCN and to gain expertise in the management of such patients and their related medical complexity.

Details

Title
Children with special health care needs attending emergency department in Italy: analysis of 3479 cases
Author
Cianci, Paola; Valeria D’Apolito; Moretti, Alex; Barbagallo, Massimo; Paci, Sabrina; Carbone, Maria Teresa; Lubrano, Riccardo; Urbino, Antonio; Carlo Dionisi Vici; Memo, Luigi; Zampino, Giuseppe; Giancarlo La Marca; Villani, Alberto; Corsello, Giovanni; Selicorni, Angelo  VIAFID ORCID Logo  ; on behalf of the Italian Society of Pediatrics (SIP); the Italian Society of Pediatric Genetic Diseases; Congenital Disabilities (SIMGePed) the Italian Society of Pediatric Emergency Medicine (SIMEUP); the Italian Society For Of Inborn Metabolic Disorders; Newborn Screening (SIMMENS); Members of Italian Network
Pages
1-9
Section
Research
Publication year
2020
Publication date
2020
Publisher
BioMed Central
ISSN
17208424
e-ISSN
18247288
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2471112599
Copyright
© 2020. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.