Why do parents use the emergency department for minor injury and illness? A cross-sectional questionnaire

Objective: To understand decision-making when bringing a child to an emergency department.

Design: A cross-sectional survey of parents attending with children allocated a minor triage category.

Setting: Emergency department in South West England, serving 450,000 people per annum.

Participants: All English-speaking parents/caregivers whose children attended the emergency department and were triaged as minor injury/illness.

Main outcome measures: Parental and child characteristics, injury/illness characteristics, advice seeking behaviour, views regarding emergency department service improvement, GP access and determinants of emergency department use.

Results: In sum, 373 responses were analysed. The majority of attendances were for minor injury, although illness was more common in <4 year olds. Most presentations were within 4 h of injury/illness and parents typically sought advice before attending. Younger parents reported feeling more stressed. Parents of younger children perceived the injury/illness to be more serious, reporting greater levels of worry, stress, helplessness and upset and less confidence. Parents educated to a higher level were more likely to administer first-aid/medication. Around 40% did not seek advice prior to attending and typically these were parents aged <24 and parents of <1 year olds. The main determinants of use were: advised by someone other than a GP; perceived urgency; perceived appropriateness. The need for reassurance also featured.

Conclusions: The findings suggest that it is difficult for parents to determine whether their child's symptoms reflect minor conditions. Efforts should focus on building parental confidence and self-help and be directed at parents of younger children and younger parents. This is in addition to appropriate minor injury/illness assessment and treatment services.