Sage Journals: Discover world-class research

Abstract

This study describes urban emergency department (ED) utilization and follow-up referral patterns among adolescents. ED visits for 14-19-year-old patients at an urban university hospital with adjacent adult and pediatric emergency departments during specified months in 1993 were retrospectively reviewed. A subgroup (n=150) was randomly selected for detailed chart review. One thousand six hundred and thirty-six adolescents were seen in the ED during the study period. Public assistance (n=763; 47%) and commercial insurance (n=480; 29%) were the most common forms of insurance, followed by self-pay (n=357; 22%). The majority of triage codes for ED visits were nonurgent (n=140; 93%). Twenty-five patients (17%) were not referred for follow-up upon ED discharge. Adolescents on public assistance or without insurance may frequently utilize an urban ED for nonurgent medical problems. A group of patients did not identify a primary care provider at triage and were not referred for follow-up. Defining medical problems for which adolescents utilize the ED may help health professionals to tailor community resources to better serve adolescent health care needs.

Get full access to this article

View all access options for this article.

References

1. Sklar HS , Downs EF . Emergency room utilization patterns of adolescents; clues to community problems. N Y State J Med. 1970;70: 643-649.

2. Walker LL . Inpatient and emergency department utilization: the effect of distance, social class, age, sex and marital status. JACEP.. 1976;5: 105-110.

3. Christoffel KK , Garside D , Tokich T . Pediatric emergency department utilization in the 1970s. An J Emerg Med. 1985;3: 177-181.

4. Ziv A , Boulet JR , Slap GB . Emergency department utilization by adolescents in the United States. Pediatrics.. 1998; 101:987-994.

5. Melzer-Lange M , Lye PS . Adolescent health care in a pediatric emergency department. Ann Eueig Med. 1996; 27:633-637.

6. Lehmann CU , Barr J , Kelly PJ . Emergency department utilization by adolescents.J Adolesc Health.. 1994;15:485-490.

7. Krauss BS , Harakal T , Fleisher GR . The spectrum and frequency of illness presenting to a pediatric emergency department. Pediatr Emerg Care.. 1991; 7:67-71.

8. Nelson DS , Walsh K , Fleisher GR . Spectrum and frequency of pediatric illness presenting to a general community hospital emergency department. Pediatrics.. 1992;90: 5-10.

9. Waldrop RD , Reine GM , Stuart MO . Influence of school enrollment on adolescent emergency department visits. J Adolesc Health. 1996;19: 416-419.

10.

10. Pane GA , Farner MC , Salness KA . Health care access problems of medically indigent emergency department walk-in patients. Ann Emerg Med. 1991;20: 730-733.

11.

11. Klein JD , McNulty M , Flatau CN . Adolescents' access to care. Arch Pediatr Adolesc Med. 1998;152: 676-682.

12.

12. Parcel GS , Nader PR , Meyer MP . Adolescent health concerns, problems and patterns of utilization in a triethnic urban population. Pediatrics.. 1977; 60:157-164.

13.

13. Litt IF , Cuskey WR , Rudd S . Emergency room evaluation of the adolescent who attempts suicide: compliance with follow-up. J Adolesc Health Care.. 1983;4:106-108.

14.

14. Vivier PM , Lewander WJ , Block SH et al. Is continuity of care preserved in children who utilize the pediatric emergency department? Pediatrics.. 1995;95:37-41.

15.

15. Guidelines for Adolescent Preventive Services. American Medical Association; 1992.

Urban Emergency Department Utilization by Adolescents

Abstract

Get full access to this article

References