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We have read the interesting clinical report on Swiss low-acuity paediatric ED visits by Manon Jaboyedoff and coworkers, published in the BMJ Paediatrics Open in November 2021.
Their main study findings confirm in much detail what our research group has already found and reported in a series of systematic clinical studies on paediatric ED care at our university hospital in southern Sweden five years ago [1-4], also defended as a PhD thesis, entitled Paediatric emergency care - seeking, triage and management, in 2018 at Lund University, Malmö, Sweden.
Most Swedish parents are aware of prehospital medical alternatives before attending a paediatric ED, and less-urgent visits can be safely redirected already on ED arrival according to predefined protocols. Lower socio-economic status is associated with less-urgent care seeking, and direct seeking of paediatric ED care is promoted by perceived medical urgency, by overestimation of actual severity, and by low availability of prehospital medical facilities, particularly outside office-hours. Hospital-based primary care facilities out-of-office-hours enable efficient management of less-urgent paediatric ED cases at more appropriate levels of medical care.
The close similarity in main findings between the present study and ours is far from surprising, when also taking the similar healthcare systems and social security patterns in various part of Europe into account.
We therefore c...
We therefore consider it worth emphasising that the present study from central Europe confirms what has recently also been found regarding low-acuity paediatric ED visits in northern Europe.
Jonas Åkeson, MD, PhD, EDAIC, ETP
Anaesthesiology and Intensive Care Medicine
Julia Ellbrant, MD, PhD
Pia Karlsland Åkeson, MD, PhD
Associate Professor/Senior Consultant
Lund University, Faculty of Medicine
1. Ellbrant J, Åkeson J, Karlsland Åkeson P. Pediatric emergency department management benefits from appropriate early redirection of nonurgent visits. Pediatr Emerg Care 2015; 31: 95-100.
2. Ellbrant J, Åkeson J, Karlsland Åkeson P. Influence of awareness and availability of medical alternatives on parents seeking paediatric emergency care. Scand J Public Health 2018; 46: 456-62.
3. Ellbrant J, Åkeson J, Eckner J, Karlsland Åkeson P. Impact of socioeconomic characteristics on use of paediatric emergency care: A questionnaire based study. BMC Emerg Med 2018; 18: 59.
4. Ellbrant J, Åkeson J, Sletten H, Eckner J, Karlsland Åkeson P. Adjacent primary care may reduce less urgent pediatric emergency department visits. J Prim Care Commun Health 2020; 11: 1–6.