Changes in pediatric emergency department utilization and health literacy: a study of non-urgent visits before and after the COVID-19 pandemic

Catarina Cezanne, Serviço de Pediatria, Hospital Garcia de Orta, Almada, Portugal
Maria Filomena Cardosa, Unidade de Gastroenterologia e Hepatologia, Hospital Dona Estefânia, Centro Hospitalar Universitário Lisboa Central, Lisboa, Portugal
Zakhar Shchomak, Serviço de Pediatria, Hospital de Santa Maria, Lisboa, Portugal
Rita Guerreiro, Serviço de Pediatria, Hospital Garcia de Orta, Almada, Portugal
Andreia Teixeira, Serviço de Pediatria, Hospital Garcia de Orta, Almada; Department of Community Medicine, Information and Decision in Health; Faculty of Medicine, University of Porto, Porto; CINTESIS@RISE - Center for Health Technology and Services Research, Porto; Faculty of Medicine, University of Porto, Porto; Portugal
Paula Pereira, Serviço de Pediatria, Hospital Garcia de Orta, Almada, Portugal
Filipa Nunes, Serviço de Pediatria, Hospital Garcia de Orta, Almada, Portugal
Bruno Sanches, Serviço de Pediatria, Hospital Garcia de Orta, Almada, Portugal

Introduction and Objectives: The overuse of emergency rooms puts strain on the National Health Service. The aim is to compare the pre- and post-pandemic reality and understand the impact on hospital resource consumption. Methods: A cross-sectional observational study was conducted on patients under 18 years of age admitted to the emergency department, who were classified as non-urgent or urgent, and a questionnaire was randomly distributed during triage. Results: A study of 511 questionnaires revealed no significant differences in sample profiles between the two time periods. The most common family type was nuclear, with an older child and regular health monitoring. The most concerning symptom was fever, leading to emergency room visits in under 48 hours with no prior medical observation. The primary reasons for emergency room visits were specialist observation and testing requirements. Approximately 30% of doctors thought the visit was justified. Discussion: Regardless of their experience and regular health monitoring, the families chose to go to the emergency room first and almost immediately. A third of the doctors thought that going to the emergency room was justified, but only a minority of the children needed interventions that would have justified going to the emergency room. To improve the rational use of the emergency room, increased awareness of health resources should be promoted amongst families and health professionals. Despite the pandemic and the decrease in emergency room visits during that time, the population’s behavior has remained consistent, and literacy issues remain unresolved. To intervene in health education, new strategies must be developed.

Keywords: Overuse. Pediatric emergency. COVID-19. Health education.