Parents’ Reasons for Bringing Young Children to Hospital Emergency for Non‐Urgent Reasons
Bibliographic record
Abstract
The use of hospital emergency departments (EDs) has increased in recent years. Within children's hospitals, use for non‐emergency reasons is dominated by young children, especially infants. A research team at the Hospital for Sick Children in Toronto, Canada sought to understand its ED use better with a view to determining the best strategic policy for dealing with its non‐emergency patients. It undertook a 2‐phase analysis of the use of its ED: the first phase (Brown & Shaw, 2000) analyzed patterns of use from the ED's database; the second phase, reported here, asked 158 parents and caregivers of patients age 0‐7 their reasons for coming to the ED. Interview questions directly addressed 11 research questions. Users of ED for non‐urgent reasons were mostly parents, fairly well educated, lived in various parts in a large urban area, and were likely to have very young and/or only children. About two‐thirds had been to the ED previously, most had taken their children to more than one health care setting, 89.9% had family physicians, most had visited their own physicians recently, most made their own decisions to come to the ED, and half knew of another place they could have gone. A wide variety of health reasons were provided for coming to this ED and for not going elsewhere, but the most common were: this hospital provides the best care, and an emergency situation was perceived. Information from this study suggests that there are no simple solutions to providing information, alternate settings, or disincentives to non‐urgent ED users for three reasons: (1) people come to EDs for a wide variety of reasons, (2) it is difficult to identify a subgroup that can be targeted for intervention, and (3) parents and caregivers may not use alternate settings or physicians. Two groups that might be targeted for intervention are parents of infants (especially first time parents), and parents of only children. Intervention should be at various levels of sophistication. High numbers of non‐urgent ED users may be ongoing, and the price some children's hospitals pay for their high profile and prestige.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.014 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".