Factors Associated with Pediatric Emergency Room Utilization in an Urban Community Hospital in Santiago, Dominican Republic

Background: In low resource settings, maximizing effective use of emergency room (ER) services is imperative. This problem is anecdotally observed in the public hospital setting in Santiago, Dominican Republic (DR). There are no studies presently published examining ER use in this pediatric populati...

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Autores principales:	Allison Lockwood, Aparna Dandekar, Margaret Arias, Massiel Ovalles, Suzanne Bentley
Formato:	article
Lenguaje:	EN
Publicado:	Ubiquity Press 2019
Materias:	Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/4aecaea8ecc04fcf8c54e45c536e1847
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spelling	oai:doaj.org-article:4aecaea8ecc04fcf8c54e45c536e18472021-12-02T09:46:29ZFactors Associated with Pediatric Emergency Room Utilization in an Urban Community Hospital in Santiago, Dominican Republic2214-999610.5334/aogh.2327https://doaj.org/article/4aecaea8ecc04fcf8c54e45c536e18472019-06-01T00:00:00Zhttps://annalsofglobalhealth.org/articles/2327https://doaj.org/toc/2214-9996Background: In low resource settings, maximizing effective use of emergency room (ER) services is imperative. This problem is anecdotally observed in the public hospital setting in Santiago, Dominican Republic (DR). There are no studies presently published examining ER use in this pediatric population or reasons caregivers choose to utilize the pediatric ER. Financial and systemic limitations have been previously cited as important contributors to the high pediatric mortality rate in the DR. Methods: In this cross-sectional, descriptive study, a survey was administered to 117 caregivers (e.g. mother, father) of children in the ER at Hospital Especializado Juan XXIII over an eight-week period. Survey questions included perceived urgency of illness, education level, monthly income, and frequency of ER visits in the last six months. We defined frequent ER visits as greater than four visits within the last six months, low income as below 10,000 pesos/month, and low education as having no high school education. Logistic regression was used to assess significant associations between variables. Results: Caregivers in the pediatric ER were predominantly female (94%) with a mean age of 30 ± 11 years. 72% of respondents reported the child’s problem as “extremely urgent,” while 82% of the children were triaged as non-urgent. Children of caregivers with any high school education had 69% lower odds of having 4 or more ED visits in the last 6 months (OR, 0.31; 95% CI, 0.13–0.75; p = 0.009), compared to children of caregivers with no high school education, after adjusting for the income category of the caregiver. Conclusions: Perceived urgency of pediatric medical problems may contribute to increased use of the ER for non-urgent medical problems. Low education level is associated with increased pediatric ER use over a six-month period. Assessing utilization of pediatric ERs in the public health care system in Santiago could provide a framework for the design of targeted educational and systemic changes, supporting the ultimate goal of providing the best possible care for pediatric patients in low-resource settings.Allison LockwoodAparna DandekarMargaret AriasMassiel OvallesSuzanne BentleyUbiquity PressarticleInfectious and parasitic diseasesRC109-216Public aspects of medicineRA1-1270ENAnnals of Global Health, Vol 85, Iss 1 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270
spellingShingle	Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270 Allison Lockwood Aparna Dandekar Margaret Arias Massiel Ovalles Suzanne Bentley Factors Associated with Pediatric Emergency Room Utilization in an Urban Community Hospital in Santiago, Dominican Republic
description	Background: In low resource settings, maximizing effective use of emergency room (ER) services is imperative. This problem is anecdotally observed in the public hospital setting in Santiago, Dominican Republic (DR). There are no studies presently published examining ER use in this pediatric population or reasons caregivers choose to utilize the pediatric ER. Financial and systemic limitations have been previously cited as important contributors to the high pediatric mortality rate in the DR. Methods: In this cross-sectional, descriptive study, a survey was administered to 117 caregivers (e.g. mother, father) of children in the ER at Hospital Especializado Juan XXIII over an eight-week period. Survey questions included perceived urgency of illness, education level, monthly income, and frequency of ER visits in the last six months. We defined frequent ER visits as greater than four visits within the last six months, low income as below 10,000 pesos/month, and low education as having no high school education. Logistic regression was used to assess significant associations between variables. Results: Caregivers in the pediatric ER were predominantly female (94%) with a mean age of 30 ± 11 years. 72% of respondents reported the child’s problem as “extremely urgent,” while 82% of the children were triaged as non-urgent. Children of caregivers with any high school education had 69% lower odds of having 4 or more ED visits in the last 6 months (OR, 0.31; 95% CI, 0.13–0.75; p = 0.009), compared to children of caregivers with no high school education, after adjusting for the income category of the caregiver. Conclusions: Perceived urgency of pediatric medical problems may contribute to increased use of the ER for non-urgent medical problems. Low education level is associated with increased pediatric ER use over a six-month period. Assessing utilization of pediatric ERs in the public health care system in Santiago could provide a framework for the design of targeted educational and systemic changes, supporting the ultimate goal of providing the best possible care for pediatric patients in low-resource settings.
format	article
author	Allison Lockwood Aparna Dandekar Margaret Arias Massiel Ovalles Suzanne Bentley
author_facet	Allison Lockwood Aparna Dandekar Margaret Arias Massiel Ovalles Suzanne Bentley
author_sort	Allison Lockwood
title	Factors Associated with Pediatric Emergency Room Utilization in an Urban Community Hospital in Santiago, Dominican Republic
title_short	Factors Associated with Pediatric Emergency Room Utilization in an Urban Community Hospital in Santiago, Dominican Republic
title_full	Factors Associated with Pediatric Emergency Room Utilization in an Urban Community Hospital in Santiago, Dominican Republic
title_fullStr	Factors Associated with Pediatric Emergency Room Utilization in an Urban Community Hospital in Santiago, Dominican Republic
title_full_unstemmed	Factors Associated with Pediatric Emergency Room Utilization in an Urban Community Hospital in Santiago, Dominican Republic
title_sort	factors associated with pediatric emergency room utilization in an urban community hospital in santiago, dominican republic
publisher	Ubiquity Press
publishDate	2019
url	https://doaj.org/article/4aecaea8ecc04fcf8c54e45c536e1847
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Factors Associated with Pediatric Emergency Room Utilization in an Urban Community Hospital in Santiago, Dominican Republic

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