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Emergency department presentations of febrile children to an Australian public hospital
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.
Funding
Royal Hobart Hospital Research Foundation
History
Publication title
Journal of Paediatrics and Child HealthVolume
54Issue
12Pagination
1308-1313ISSN
1034-4810Department/School
School of Pharmacy and PharmacologyPublisher
Blackwell Publishing AsiaPlace of publication
54 University St, P O Box 378, Carlton, Australia, Victoria, 3053Rights statement
Copyright 2018 Paediatrics and Child Health Division (The Royal Australasian College of Physicians)Repository Status
- Restricted