The 130th Annual Meeting of APHA

Abstract #50219

Sally Findley, PhD¹, Matilde Irigoyen, MD², Steven Miller, MD³, and Maria Moreno¹. (1) Joseph L. Mailman School of Public Health, Columbia University, 60 Haven Ave, B-2, New York, NY 10032, 212 304-5790, sef5@columbia.edu, (2) Division of General Pediatrics, Columbia University, 622 W. 168th St., VC4-402, New York, NY 10032, (3) Division of Pediatrics, Columbia University, 622 W. 168th St., BHN 518, New York, NY 10032

Background: Recurrent use of Pediatric Emergency Departments (PED) remains a feature of low-income urban communities, despite expansion of CHIP.

Methods: In a low-income community in NYC we surveyed 150 parents of children <19 years coming to a PED for non-trauma care at randomly selected time periods daily between 9AM-12MN. Bilingual interviewers asked about reasons for PED use, usual source of primary care (PCP) and insurance coverage.

Results: Children averaged 1.8 years old, with 74% Latino, 12% African-American. 56% had Medicaid, 5% CHP, 23% private insurance, and 7% uninsured. 92% had a PCP, averaging 5 visits to the PCP in the past year. 95% of parents were satisfied with their PCP. 73% found it very easy to see their PCP on short notice, but 18% could not get to the PCP during normal hours. 71% had made at least 1 other ED visit in the year, and 18% had made >5 visits. Only 13% came to the PED that day for an emergency. 18% came because they could not get to the PCP on time; 25% preferred ED services and quality of care. 50% of the visits were non-urgent, chiefly for fever, asthma, and stomach pains.

Conclusions: Despite adequate insurance and regular PCP use, most children going to the PED did so repeatedly for non-urgent concerns. Parents preferred the ED for perceived high quality care and accessibility. Reversing trends of recurrent ED use requires better understanding of why people may prefer the ED, as well as improvements in primary care access.

Learning Objectives:

• The participants will learn what are the main reasons for pediatric ED use and factors that affect it, like insurance status and source of primary care.

Keywords: Emergency Department/Room, Access to Care

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.