5.8.1 Predictors of parental attendance with children presenting with minor illness at an Accident and Emergency (A&E) department and General Practice (GP) services (145)

Pippa Hemingway, Research Fellow, School of Nursing, University of Nottingham, Nottingham, United Kingdom Co authors: Roderick MacFaul, Kate Armon, Ursula Werneke, Monica Lakhanpaul & Terence Stephenson. pippa.hemingway@nottingham.ac.uk

Abstract:

Background:

UK child A&E attendances are rising with 3.5 million children attending A&E annually (Office for National Statistics 2004). However the factors determining child A&E attendance as compared to GP attendance remain unclear (Hendry et al 2005).

Aims:

The study identified the factors that predicted parental A&E attendance with children presenting with minor illness compared to an equivalent group attending GP services.

Methods:

This prospective case-control study recruited an opportunistic sample of parents of children with minor illness attending A&E or GP services (2:1 cases/controls): Cases: Parents attending A&E at Queen¡¯s Medical Centre, Nottingham. Controls: Parents attending one of 6 GP surgeries or 1 out-of-hours GP cooperative in Nottingham. Parents completed a structured questionnaire developed from prior qualitative work (Eccleston et al 2001). Data were analysed by uni- and multivariate analysis using SPSS(TM).

Results:

In 2000, 411 subjects were recruited (272 cases, 139 controls; 87% response rate). Four variables significantly determined parental A&E attendance with children (¡Ü 15 yr) presenting with minor illness (n=148); parents with no past experience of the respective childhood illness (p=0.018), attending with a child in pain (p=0.002), a high perceived need for hospital admission (p=0.003) and being a male parent/carer (p=0.036) were all more likely to attend A&E, independent of child illness severity (p=0.087, U=14592, n=377).

Discussion:

The identified predictors of A&E attendance should inform the current debate regarding child emergency care service development in the UK and elsewhere. These data address the enduring call for such data obtained across A&E and GP based services (Hendry et al 2005). Conclusions Parents of children with minor illness reported 4 factors which significantly contributed to their A&E attendance rather than attending GP services (independent of child illness severity), which may assist in directing resources intended to reform child emergency care and develop parent centred services.

Biography:

Dr Pippa Hemingway (PhD (Nottingham) BSc. (hons) (Hull), RSCN, RGN) is a Research Fellow for the Centre of Evidence Based Nursing and Midwifery (CEBNW) at the School of Nursing, University of Nottingham. The data in the abstract were collected whilst she was a Nurse Researcher at the Academic Division of Child Health, University of Nottingham and she remains a member of the Paediatric A&E Research Group (PAERG). In 1998, Dr Hemingway was nominated as a life-time member of the Paediatric Research Society (PRS). Currently, Dr Hemingway¡¯s work involves being a primary and secondary systematic reviewer for the Centre of Evidence Based Nursing and Midwifery: a collaborating centre of the international Joanna Briggs Institute (JBI). Dr Hemingway also teaches pre and post registered nurses at the School of Nursing, University of Nottingham. Her research interests are currently the systematic review of non-RCT evidence using JBI methods and clearly her work on parental service use for childhood minor illness continues. Acknowledgement: The investigators would like to thank all the parents and staff involved in the discussed study.