[The pediatric emergency department: assessment of clinical activity and interaction with local health authorities].
A perspective study was carried out at the Emergency Department of the Gaslini Institute on a sample of the children admitted from May to September 1990. The study aimed to describe types and modalities of admission. "G. Gaslini" Institute is a multidisciplinary children's hospital: 45% of patients admitted in the hospital come from the southern regions of Italy, while the admission at the Emergency Department were local in 82%. Among all children considered, 2080 (71.9% were admitted on request of their parents, who did not ask previously any physician; of those cases, 356 (17%) were hospitalized, 474 (25%) were either examined by specialist or treated and then discharged. In the remaining cases, no intervention was necessary. As a consequence, 58% of children were admitted without any clinically plausible reason. Parents' anxiety clearly played an important role in most cases. 840 children were addressed to the Emergency Department by a physician, 652 (22.3%) by the doctor in charge, 213 (32.7%) of which were sent back home by the doctor on duty, who did not think it necessary any treatment. Of the 120 (4.1%) children sent by different Emergency Departments, 95 (79.1%) were hospitalized. The reason why physicians addressed quite a large number of children to the Emergency Department, when they didn't need any intervention remain nucleo. Their diagnosis, in fact, agreed with those of the doctor on duty in 83% of cases. In conclusion, it is difficult to imagine a diagnostic or therapeutic problem which needs specific structures. Cooperative programs with physicians working in our region will be carried out in order to control, where possible, admission to Emergency Departments.
Lattere
M
M
Servizio di P.S., Accettazione e Osservazione, Istituto Scientifico G. Gaslini, Genova.
Rosati
U
U
Chiossi
M
M
Facco
F
F
Magnani
M
M
Calvi
A
A
Renna
S
S
Bonassi
S
S
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D006801:Humans; D007223:Infant; D007558:Italy; D010343:Patient Admission / Q000706:statistics & numerical data; D010372:Pediatrics; D011446:Prospective Studies
Il pronto soccorso pediatrico: valutazione dell'attività e interazione con i servizi territoriali.