Bereznicki, BJ and Tucker, MGA and Beggs, SA and Zosky, GR and Bereznicki, LRE, Emergency department presentations of febrile children to an Australian public hospital, Journal of Paediatrics and Child Health, 54, (12) pp. 1308-1313. ISSN 1034-4810 (2018) [Refereed Article]
Copyright 2018 Paediatrics and Child Health Division (The Royal Australasian College of Physicians)
Aim: We investigated the presentations of children with unspecified fever to an Australian emergency department (ED): (i) to determine the proportion of these presentations that could be classified as potentially avoidable and (ii) to identify factors associated with an increased risk of hospital admission.
Methods: This study retrospectively identified and described children aged <6 years who presented to the Royal Hobart Hospital (Tasmania, Australia) ED with unspecified fever (ICD-10-AM code R50.9) between January 2013 and December 2015, using data from the ED information system and digital medical records. The Australian Institute of Health and Welfare method was used to estimate the number of potentially avoidable general practitioner-type presentations. Predictors of hospital admission were determined using multivariate logistic regression.
Results: A total of 459 patients aged <6 years presented to the ED with a primary diagnosis description of unspecified fever. Of these, 30.7% were classed as potentially avoidable general practitioner-type presentations. Overall, 26.1% of presentations resulted in admission to hospital. Administration of intravenous fluids in the ED and a longer treat time were identified as significant predictors of a child with non-specific fever being admitted to hospital. Older age, administration of antipyretics in the ED and presentations triaged as semi-urgent and non-urgent significantly reduced the probability of admission.
Conclusions: To our knowledge, this is the first Australian study that has assessed the impact of unspecified childhood fever on an Australian ED. Further investigation of presentations classified as potentially avoidable is warranted to investigate whether these could be managed in the primary care setting.
|Item Type:||Refereed Article|
|Keywords:||emergency department child fever, emergency medicine, fever|
|Research Division:||Health Sciences|
|Research Group:||Health services and systems|
|Research Field:||Health and community services|
|Objective Group:||Specific population health (excl. Indigenous health)|
|Objective Field:||Neonatal and child health|
|UTAS Author:||Bereznicki, BJ (Dr Bonnie Bereznicki)|
|UTAS Author:||Tucker, MGA (Ms Madeline Tucker)|
|UTAS Author:||Zosky, GR (Professor Graeme Zosky)|
|UTAS Author:||Bereznicki, LRE (Professor Luke Bereznicki)|
|Web of Science® Times Cited:||3|
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