Association between the use of an app for providing healthcare information for parents and urgent emergency department visits for children: a cross-sectional study in Japan

Abstract

Objective: To evaluate the association between the use of medical information applications and urgent emergency room consultation behaviour among parents who visited the emergency department (ED) of their children.

Design: Cross-sectional survey.

Setting: A primary-level paediatric emergency medical facility in Nagano Prefecture.

Participants: Parents of children aged 8 years or younger who had visited the medical facility between December 2023 and March 2024.

Primary and secondary outcome measures: The primary outcome was defined as an association between the urgency of ED visits and parental use of mobile applications. The secondary outcome was the association between the urgency of ED visits and app evaluations among parents using the app. The urgency of the ED visits was classified according to the Japan Triage and Acuity Scale.

Results: In total, 386 parents participated in this study (response rate: 91%). Among these, 77% were mothers and the median age was 36.3 years. Of the ED visits by app users, 63.7% were classified as urgent, compared with 41.7% of visits by non-users (adjusted OR: 2.8, 95% CI: 1.7 to 4.7, p<0.001). Among the participants who used the app, 94.4% answered that they would recommend the app and 87.0% answered that the app made it easier to decide whether to visit the hospital. In addition, the proportion of children who revisited the ED within 6 months was higher for children with a medical history than for those without such a history. There were no significant associations between the urgency of ED visits and parental education, self-reported financial status, or whether the parent was a healthcare professional.

Conclusions: The use of the medical information app was significantly associated with parental ED urgency. These findings suggest that such apps may support informed decision-making in paediatric emergency care. Future research should investigate the effect of this app on a broader population, including cases involving ambulance transport.

Keywords: Community child health; Digital Technology; Health Literacy; Parents; Triage.

Figure 1. Examples of images of the main modules of the ‘Teach Me! Doctor’ App. Left: Top image of the app. Middle: Criteria to determine whether to call an ambulance when a seizure occurs. Right: Table of contents to determine the suitable response to the child’s symptoms. The original app showed menu names in Japanese, which have been translated into English.

Figure 2. Flow diagram of the study. 386 valid participants were received from 425 eligible participants (response rate 91%).