Purpose It has been reported that adolescents often come to the emergency department (ED) for non-urgent care and frequently come alone. In this study we surveyed adolescents regarding their use of our ED and routine medical care, as well as transportation, insurance status and parental presence at time of ED visit.
Methods A questionnaire was constructed to elicit adolescent's perspective of appropriateness of their ED visit and to determine their access to routine medical care. A convenience sample of adolescents, age 13-19, who presented to our Children's Hospital ED were surveyed with all three shifts represented. Data were entered into EpiStat®.
Results A total of 162 patients were enrolled (0% refusal), with 56% being female and 65% African American (30% Caucasian). Six and one-half percent came alone, while 67% were accompanied by a parent, yet 11% were seen in the examination room alone. Of those coming alone, 73% had no driver's license and 63.6% identified a chronic medical condition. In addition, 81% were triaged as urgent or emergent. Overall, 75% were triaged as urgent or emergent. Thirty-three percent of the teenagers presenting felt they had an emergent problem, while 22% were referred to the ED by their pediatrician. Eighty percent identified a primary care physician (PCP) and 86% were insured, yet 36% reported using the ED > 5 times in their lifetime. Thirty-three percent reported seeing their PCP in the last month. Eighty-three percent arrived by private auto and 13.5% by ambulance.
Conclusion The common belief that adolescents seek emergency department care for nonurgent issues is disproved here. They also displayed skillful perception of their acuity level, evidenced by their close correlation to the level of triage assigned. Most were insured and identified a medical home.
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