title: Parental reasons for utilization of an urban pediatric emergency department during the 2009 H1N1 influenza epidemic.
abstract: OBJECTIVE
  The objective of the study was to understand the utilization of the pediatric emergency department (PED) of an academic hospital during regular primary care office hours during the 2009 H1N1 epidemic. Children with a usual source of care presenting for influenza-like illness (ILI) symptoms were compared with those presenting with other symptoms.
  
  
  METHODS
  During the 2009 H1N1 outbreak, parents visiting a PED in a low-income area in New York City in June 2009 were surveyed using open- and close-ended questions. Sociodemographic factors and reasons for seeking care in the PED rather than their usual source of care were compared between groups.
  
  
  RESULTS
  There were no sociodemographic differences among children brought to the PED for ILI and those brought for other presenting symptoms. Those families with a child with ILI symptoms were less likely to report urgency as the primary reason they brought their child to the PED. A common reason reported for coming to the PED was limited access to care. In further exploration of limited access, parents with a child with ILI symptoms were more likely to report that their usual source of care did not have any evening and/or weekend hours, and they did not know how to reach their provider after hours.
  
  
  CONCLUSIONS
  Enhancing access to primary care settings and encouraging parents to use their primary care providers might reduce the utilization of the PED for nonurgent problems during epidemics.
authors.affiliation: Division of General Pediatrics, Department of Pediatrics, College of Physicians and Surgeons, Columbia University, 622 W 168th St, VC 402, New York, NY 10032, USA. mstockwell@columbia.edu
authors.forename: Melissa S
authors.initials: MS
authors.lastname: Stockwell
authors.forename: John
authors.initials: J
authors.lastname: Rausch
authors.forename: Meridith
authors.initials: M
authors.lastname: Sonnett
authors.forename: Lawrence R
authors.initials: LR
authors.lastname: Stanberry
authors.forename: Susan L
authors.initials: SL
authors.lastname: Rosenthal
mesh_terms: D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D058872:Epidemics; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D010290:Parents; D014504:Urban Health