Characteristics of unscheduled pediatric emergency department discharges in Ontario hospitals between 2010 and 2019
| Characteristic | No. (%)* | |||
|---|---|---|---|---|
| Patients with bronchiolitis n = 60 914 | Patients with asthma n = 141 921 | Patients with abdominal pain n = 333 332 | Patients with constipation n = 110 514 | |
| Clinical characteristics | ||||
| Age, yr, mean ± SD | 0.7 ± 1.6 | 7.4 ± 5.2 | 11.1 ± 5.1 | 6.4 ± 5.2 |
| Sex, female | 23 305 (38.3) | 53 999 (38.0) | 199 573 (59.9) | 58 142 (52.6) |
| Neighbourhood income quintile† | ||||
| 1 (low) | 15 170 (24.9) | 34 622 (24.4) | 69 313 (20.8) | 26 020 (23.5) |
| 2 | 11 801 (19.4) | 28 750 (20.3) | 63 696 (19.1) | 21 958 (19.9) |
| 3 | 12 235 (20.1) | 28 054 (19.8) | 66 582 (20.0) | 22 265 (20.1) |
| 4 | 12 428 (20.4) | 26 840 (18.9) | 69 760 (20.9) | 22 176 (20.1) |
| 5 (high) | 8993 (14.8) | 23 043 (16.2) | 62 896 (18.9) | 17 666 (16.0) |
| Rurality† | ||||
| Rural | 8813 (14.5) | 25 746 (18.1) | 48 779 (14.6) | 18 235 (16.5) |
| Immigrant or refugee status | 226 (0.4) | 2938 (2.1) | 18 887 (5.7) | 3450 (3.1) |
| Chronic complex condition | 1544 (2.5) | 1978 (1.4) | 6837 (2.1) | 2524 (2.3) |
| CTAS score† | ||||
| 1 | 711 (1.2) | 2119 (1.5) | 192 (0.1) | 71 (0.1) |
| 2 | 21 678 (35.6) | 44 856 (31.6) | 42 427 (12.7) | 10 035 (9.1) |
| 3 | 30 865 (50.7) | 66 914 (47.1) | 224 568 (67.4) | 62 584 (56.6) |
| 4 | 7096 (11.6) | 25 407 (17.9) | 60 726 (18.2) | 33 745 (30.5) |
| 5 | 480 (0.8) | 2358 (1.7) | 4921 (1.5) | 3884 (3.5) |
| Time of ED presentation | ||||
| Mon.–Fri.: 08:01 to 16:00 | 17 995 (29.5) | 36 232 (25.5) | 102 679 (30.8) | 33 634 (30.4) |
| Mon.–Fri.: 16:01 to 24:00 or Sat./Sun.: 08:01 to 16:00 | 25 479 (41.8) | 56 697 (39.9) | 135 920 (40.8) | 46 643 (42.2) |
| Mon.–Fri.: 00:01 to 08:00 or Sat./Sun.: 16:01 to 08:00 | 15 052 (24.7) | 44 476 (31.3) | 87 294 (26.2) | 27 166 (24.6) |
| Holidays | 2388 (3.9) | 4,516 (3.2) | 7439 (2.2) | 3071 (2.0) |
| ED length of visit, h | ||||
| < 2 | 18 030 (29.6) | 49 204 (34.7) | 82 021 (24.6) | 37 380 (33.8) |
| 2–4 | 26 800 (44.0) | 57 395 (40.4) | 132 409 (24.6) | 47 664 (43.1) |
| 4–6 | 11 125 (18.3) | 23 786 (16.8) | 74 247 (22.3) | 17 909 (16.2) |
| ≥ 6 | 4890 (8.0) | 11 247 (7.9) | 43 785 (13.1) | 7278 (6.6) |
| Physician characteristics | ||||
| Physician specialty† | ||||
| PEM | 9895 (16.2) | 16 837 (11.9) | 25 017 (7.5) | 13 487 (12.2) |
| EM | 3267 (5.4) | 7568 (5.3) | 25 995 (7.8) | 6376 (5.8) |
| FP + EM | 21 224 (34.8) | 52 564 (37.0) | 149 865 (45.0) | 36 239 (32.8) |
| Pediatrics | 8810 (14.5) | 13 075 (9.2) | 21 077 (6.3) | 14 251 (12.9) |
| GP or FP | 14 809 (24.3) | 45 503 (32.1) | 97 388 (29.2) | 34 289 (31.0) |
| Other‡ | 1280 (2.1) | 2197 (1.5) | 7554 (2.3) | 3036 (2.7) |
| Sex† | ||||
| Female | 19 635 (32.2) | 38 876 (27.4) | 90 286 (27.1) | 34 580 (31.3) |
| Age, yr, mean ± SD | 44.3 ± 9.0 | 44.7 ± 9.5 | 43.9 ± 9.2 | 44.5 ± 9.4 |
| Years in practice† mean ± SD | 15.9 ± 10.2 | 16.7 ± 10.7 | 15.7 ± 10.3 | 16.1 ± 10.5 |
| International medical graduate† | 8914 (14.6) | 17 914 (12.6) | 41 335 (29.8) | 35 166 (31.8) |
| Hospital characteristics | ||||
| Hospital type | ||||
| Pediatric academic hospitals, n = 4 | 19 612 (32.2) | 31 430 (22.1) | 54 017 (16.2) | 32 592 (29.5) |
| Academic hospitals, n = 18 | 1927 (3.2) | 5368 (3.8) | 20 147 (6.0) | 4454 (4.0) |
| Community hospitals with pediatric consultation, n = 52 | 27 806 (45.6) | 65 212 (45.9) | 183 374 (55.0) | 46 131 (41.7) |
| All other community hospitals, n = 107 | 11 569 (19.0) | 39 911 (28.1) | 75 794 (22.7) | 27 337 (24.7) |
| ED volume | ||||
| Low | 2056 (3.4) | 9777 (6.9) | 20 357 (6.1) | 6070 (5.5) |
| Medium | 8391 (13.8) | 26 355 (18.6) | 55 458 (16.6) | 19 061 (17.2) |
| High | 50 467 (82.8) | 105789 (74.5) | 257 517 (77.3) | 85 383 (77.3) |
Note: CTAS = Canadian Triage Acuity Scale, ED = emergency department, EM = emergency medicine, FP = family practice, GP = general practice, PEM = pediatric emergency medicine, SD = standard deviation.
↵* Unless otherwise specified.
↵† Missing data were limited to the following variables: neighbourhood income quintile (n = 2413 [0.4%]), rurality (n = 831 [0.1%]), CTAS score (n = 1054 [0.3%]), physician specialty (n = 15 078 [2.3%]), physician sex (n = 15 078 [2.3%]) and physician years in practice (n = 15 092 [2.3%]), and physician domestic v. international training (n = 77154 [11.9%]).
↵‡ Other physician specialties included critical care medicine, psychiatry, internal medicine, anesthesiology, orthopedic surgery, cardiology, nuclear medicine, otolaryngology, neonatal medicine, general surgery and 44 others.