Skip to main content
PMC home page
The Ulster Medical Journal logoLink to The Ulster Medical Journal
. 1989 Apr;58(1):29–35.

Primary medical care in a paediatric accident and emergency department.

M C Stewart, J M Savage, M J Scott, B G McClure
PMCID: PMC2448563  PMID: 2773168

Abstract

The characteristics of a random sample of 853 children who attended the accident and emergency department of the Royal Belfast Hospital for Sick Children were studied prospectively to determine the extent to which the department was being used to provide primary medical care. Direct parent referrals accounted for 69% of all attendances with a further 21% referred by the family doctor. Parental preference and accessibility were the main reasons given for choosing to attend the department with the latter significantly higher among out-of-hours attendances. However, only 37 of the 585 parent referrals had made an attempt to contact the family doctor. Overall, 33.9% of children were felt to be inappropriate attenders, i.e. were neither accident nor emergency cases, and the proportion was highest among the parent-referred groups. The present financial restraints facing the National Health Service make it uneconomical to provide primary medical care at both hospital and community level. However, the level of demand for the accident and emergency department, together with the attitudes of those who attend, make it unlikely that a more rational use of resources will be achieved in the foreseeable future.

Full text

PDF
29

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BERGMAN A. B., HAGGERTY R. J. The emergency clinic. A study of its role in a teaching hospital. Am J Dis Child. 1962 Jul;104:36–44. [PubMed] [Google Scholar]
  2. Crombie D. L. A Casualty Survey. J Coll Gen Pract Res Newsl. 1959 Nov;2(4):346–356. [PMC free article] [PubMed] [Google Scholar]
  3. Davies T. Accident department or general practice? Br Med J (Clin Res Ed) 1986 Jan 25;292(6515):241–243. doi: 10.1136/bmj.292.6515.241. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Halperin R., Meyers A. R., Alpert J. J. Utilization of pediatric emergency services: a critical review. Pediatr Clin North Am. 1979 Nov;26(4):747–757. doi: 10.1016/s0031-3955(16)33781-6. [DOI] [PubMed] [Google Scholar]
  5. Jackson R. H. Children in accident and emergency departments. Br Med J (Clin Res Ed) 1985 Oct 12;291(6501):991–992. doi: 10.1136/bmj.291.6501.991. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Kahn L., Anderson M., Perkoff G. T. Patient's perceptions and uses of a pediatric emergency room. Soc Sci Med. 1973 Feb;7(2):155–160. doi: 10.1016/0037-7856(73)90157-1. [DOI] [PubMed] [Google Scholar]
  7. Reilly P. M. Primary care and accident and emergency departments in an urban area. J R Coll Gen Pract. 1981 Apr;31(225):223–230. [PMC free article] [PubMed] [Google Scholar]
  8. Wilkinson A., Kazantzis G., Williams D. J., Dewar R. A., Bristow K. M., Miller D. L. Attendance at a London casualty department. J R Coll Gen Pract. 1977 Dec;27(185):727–733. [PMC free article] [PubMed] [Google Scholar]
  9. Wingert W. A., Friedman D. B., Larson W. R. Pediatric emergency room patient. A comparison of patients seen during the day and at night. Am J Dis Child. 1968 Jan;115(1):48–56. doi: 10.1001/archpedi.1968.02100010050009. [DOI] [PubMed] [Google Scholar]

Articles from The Ulster Medical Journal are provided here courtesy of Ulster Medical Society

RESOURCES