Why do parents use the emergency department for minor injury and illness? A cross-sectional questionnaire

Abstract

Objective To understand decision-making when bringing a child to an emergency department. Design A cross-sectional survey of parents attending with children allocated a minor triage category. Setting Emergency department in South West England, serving 450,000 people per annum. Participants All English-speaking parents/caregivers whose children attended the emergency department and were triaged as minor injury/illness. Main outcome measures Parental and child characteristics, injury/illness characteristics, advice seeking behaviour, views regarding emergency department service improvement, GP access and determinants of emergency department use. Results In sum, 373 responses were analysed. The majority of attendances were for minor injury, although illness was more common in <4 year olds. Most presentations were within 4 h of injury/illness and parents typically sought advice before attending. Younger parents reported feeling more stressed. Parents of younger children perceived the injury/illness to be more serious, reporting greater levels of worry, stress, helplessness and upset and less confidence. Parents educated to a higher level were more likely to administer first-aid/medication. Around 40% did not seek advice prior to attending and typically these were parents aged <24 and parents of <1 year olds. The main determinants of use were: advised by someone other than a GP; perceived urgency; perceived appropriateness. The need for reassurance also featured. Conclusions The findings suggest that it is difficult for parents to determine whether their child’s symptoms reflect minor conditions. Efforts should focus on building parental confidence and self-help and be directed at parents of younger children and younger parents. This is in addition to appropriate minor injury/illness assessment and treatment services.