TY - JOUR T1 - Putting rising emergency hospital admissions for children into perspective: how do international comparisons help? JF - BMJ Quality & Safety JO - BMJ Qual Saf SP - 7 LP - 10 DO - 10.1136/bmjqs-2017-006951 VL - 27 IS - 1 AU - Lucia Kossarova AU - Eilís Keeble Y1 - 2018/01/01 UR - http://qualitysafety.bmj.com/content/27/1/7.abstract N2 - Emergency department (ED) visits and hospital admissions are often monitored to get an understanding of urgent hospital activity, but are also used as an indicator of the accessibility and quality of services outside the hospital. The factors determining whether or not a family will seek care in the ED and be admitted are complex (figure 1), and this picture becomes even more complex when comparing between areas or countries. One thing that can be counted on, however, is that regardless of country, nationality, health system or personal preferences, all parents are likely to want the same for their child: for them to receive the best care possible—care that is easily accessible, safe, effective, most appropriate for their needs and provided in a caring environment.Figure 1 Factors influencing the use of emergency hospital care by children and young people (A&E: Accident and Emergency Department).When a parent becomes concerned about their child’s health, they need reassurance and advice which may or may not lead to a hospital stay. Where they seek care will depend on a number of factors: how unwell the child seems to them, how knowledgeable and empowered they feel to help their child without medical advice, the time of the day and other responsibilities they may have (eg, work, another child and others), as well as what health professional is accessible to them and how much they trust their advice. Any previous experience with the healthcare system will also be an important factor in deciding what to do and where to seek help—be it at the ED of the hospital, an urgent care centre, the local general practitioner, paediatrician or nurse.The options available to parents vary by country (or even by region), and these differences may lead to different outcomes, but not always. There can be different clinical interventions and … ER -