Nonurgent emergency-department care: analysis of parent and primary physician perspectives. Pediatrics 2011 Feb;127(2):e375-81
Date
01/19/2011Pubmed ID
21242226DOI
10.1542/peds.2010-1723Scopus ID
2-s2.0-79551557243 (requires institutional sign-in at Scopus site) 60 CitationsAbstract
OBJECTIVE: To better understand parental decisions to seek care for their children and physician perceptions of parents' decisions to seek nonurgent emergency-department care.
PATIENTS AND METHODS: In-depth interviews of 26 parents of children and 20 primary care physicians of the same children presenting for nonurgent care at a children's hospital emergency department were completed. Parent accounts of events that preceded the emergency-department visit were coded and qualitatively analyzed for themes. Physician evaluations of the accounts of events and parental decisions were ascertained through interviews with primary care physicians, who also described their practice characteristics. The parent/physician analyses allowed for an investigation of all aspects of the child's care and were designed to reveal differences between parent and physician beliefs.
RESULTS: Parents believed that they acted appropriately, and physicians approved of parents' decisions. Four main themes emerged: (1) immediate reassurance that their children are safe from harm is critical to parents' decisions; (2) primary care offices lack specific tests and treatments that parents and physicians believe may be necessary, regardless of whether they are actually needed; (3) discrepancies exist between physician and parent perceptions of adequate communication and access; and (4) nonurgent emergency-department visits are not perceived as a significant enough breach in continuity of care by physicians and parents to warrant any concern.
CONCLUSIONS: When individual interviews were evaluated, neither parents nor primary care physicians saw nonurgent emergency-department visits as a significant enough problem to warrant any change in physician care practices or parent care-seeking behavior.
Author List
Brousseau DC, Nimmer MR, Yunk NL, Nattinger AB, Greer AAuthor
Ann B. Nattinger MD, MPH Associate Provost, Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Child, PreschoolEmergency Medical Services
Emergency Service, Hospital
Female
Health Services Misuse
Humans
Infant
Male
Parents
Physician-Patient Relations
Physicians, Primary Care
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