TOP 38 - Trends in Pediatric Emergency Department Utilization and Reliance

Publication Number: 4740.TOP 38

Lukas Gaffney, Boston Children's Hospital, Brookline, MA, United States; Todd Lyons, Harvard Medical School/Boston Children's Hospital, Wayland, MA, United States

Background: Pediatric emergency department (ED) utilization changed dramatically during the COVID pandemic, with a marked decrease in overall utilization beginning in March 2020. However, little is known about how pediatric ED use has changed since that time.

Objective: Our study has two aims: (1) to measure trends in yearly national pediatric ED use, and (2) to measure trends in rates of high ED utilization and reliance among pediatric patients.

Design/Methods: We performed a retrospective cross-sectional study of children < 18 years old from 2017-2023 using the Medical Expenditure Panel Survey (MEPS), a nationally representative survey. Our primary outcome was total ED visits. Our secondary outcomes were high ED utilization (2 or more ED visits annually) and high ED reliance (one-third or more of all medical visits occurring in the ED). We measured overall ED visits as well as percentage of patients with high ED utilization and ED reliance over time.

To date, we have collected all data and have preliminary estimates of overall ED utilization, high ED utilization and high ED reliance over the study period (Table 1). In the coming weeks, we will work with our statistician to define our analytical approach to determine yearly variation and trends in our outcomes over the study period. We anticipate completing this analysis and generating figures by the end of November. This study was determined to not meet criteria for human subject research by our institutional IRB.

Table 1
Yearly national pediatric emergency department visits and percentage of children with high emergency department utilization (ED Util, ≥2 visits per year) and high emergency department reliance (EDR, >0.33 of all healthcare visits to emergency department).