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. 2014 Aug;49(4):1290-305.
doi: 10.1111/1475-6773.12161. Epub 2014 Feb 5.

The burden of inappropriate emergency department pediatric visits: why Italy needs an urgent reform

Alessio Vedovetto  1 , Nicola Soriani, Emanuela Merlo, Dario Gregori
Affiliations

The burden of inappropriate emergency department pediatric visits: why Italy needs an urgent reform

Alessio Vedovetto et al. Health Serv Res. 2014 Aug.

Abstract

Objective: To better understand the issue of inappropriate pediatric Emergency Department (ED) visits in Italy, including the impact of the last National Health System reform.

Study design: A retrospective cohort study was conducted with five health care providers in the Veneto region (Italy) in a 2-year period (2010-2011). ED visits were considered "inappropriate" by evaluating both nursing triage and resource utilization, as addressed by the Italian Ministry of Health in 2007. Factors associated with inappropriate ED visits were identified. The cost of each visit was calculated.

Principal findings: In total, 134,358 ED visits with 455,650 performed procedures were recorded in the 2-year period; of these, 76,680 (57.1 percent) were considered inappropriate ED visits. Patients likely to make inappropriate ED visits were younger, female, visiting the ED during night or holiday, when the primary care provider (PCP) is not available.

Conclusion: The National Health System reform aims to improve efficiency, effectiveness, and costs by opening PCP offices 24 hours a day and 7 days a week. This study highlights the need for a deep reorganization of the Italian Primary Care System not only providing a larger time availability but also treating the parents' lack of education on children's health.

Keywords: Nonurgent; health expenditure; inappropriate; pediatric emergency department; reorganization.

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Figures

Figure 1
Figure 1
From Left Upper Corner. (a) Number of Visits per Day: Workday/Holiday. (b) Number of Visits per Day: Appropriate/Inappropriate. (c) Number of Inappropriate Visits: Workday/Holiday. (d) Number of Inappropriate Visits: Primary Care Provider (PCP) Available/Not Available
See this image and copyright information in PMC

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