Characteristics of nonurgent emergency department use in the first 3 months of life

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ObjectivesTo determine the characteristics of nonurgent emergency department (ED) visits in the first 3 months of life.MethodsThe study cohort consisted of full-term newborns admitted to and discharged from one newborn nursery from September 1, 1992, to May 1, 1994. All visits in the first 90 days of life to one large urban ED were analyzed to determine whether they were nonurgent, based on history of present illness and final diagnosis or disposition. The principal outcomes of interest were the frequency and pattern of nonurgent ED visits. Risk factors for nonurgent ED use were also studied.ResultsA total of 2137 patients with 965 ED visits were analyzed; 20.4% of the patients had nonurgent visits, and 60.1% of all visits were nonurgent. Of all patients with nonurgent visits, 24.1% had more than one. Younger maternal age, Medicaid, maternal parity, and nonwhite race all resulted in increased nonurgent ED use. One third of all ED visits were made when the primary care physician’s offices were open, and 57.6% of these visits were nonurgent.ConclusionsMaternal and economic factors affected nonurgent ED utilization. Other critical factors still need to be explored. Interventions focused on decreasing nonurgent ED use in early infancy should be targeted at patients with the identified risk factors.

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