The Paradox of Crowded Paediatric Emergencies in a Shrinking Population
A 23-year analysis of a major Italian children’s hospital reveals a critical paradox in healthcare utilization: despite a significant decline in birth rates and the paediatric population, visits to the paediatric emergency department (PED) have risen sharply. The study, covering over 840,000 visits, found that while hospitalisations per 1,000 PED visits and per 1,000 young residents decreased, the rate of PED visits per 1,000 live births increased substantially. This trend persisted even after excluding the anomalous COVID-19 years, indicating the increase is driven by non-urgent cases rather than genuine emergencies. The findings point to systemic inefficiencies and behavioural factors, such as parental health-seeking patterns and potential gaps in primary care access, leading to inappropriate emergency department use and crowding.
Why it might matter to you: For professionals focused on infectious diseases and outbreak surveillance, this research highlights a key pressure point in healthcare systems that can exacerbate transmission dynamics during epidemics. Crowded emergency departments become high-risk environments for spreading respiratory and other contagious pathogens. Understanding the drivers of non-urgent PED use is crucial for designing effective public health messaging and infection control strategies during seasonal outbreaks or pandemics, helping to protect vulnerable paediatric populations and reduce the burden on emergency services.
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