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Clinical Pediatrics, Vol. 39, No. 8, 479-483 (2000)
DOI: 10.1177/000992280003900806

Urban Emergency Department Utilization by Adolescents

Deanna Dahl Grove, MD

Department of Pediatrics, Division of Pediatric Emergency Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio

Rina Lazebnik, MD

Division of General Academic Pediatrics, Case Western Reserve University School of Medicine, Cleveland, Ohio

Emory M. Petrack, MD, MPH

Department of Pediatrics, Division of Pediatric Emergency Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio

This study describes urban emergency department (ED) utilization and follow-up referral patterns among adolescents. ED visits for 14-19-year-old patients at an urban university hospital with adjacent adult and pediatric emergency departments during specified months in 1993 were retrospectively reviewed. A subgroup (n=150) was randomly selected for detailed chart review. One thousand six hundred and thirty-six adolescents were seen in the ED during the study period. Public assistance (n=763; 47%) and commercial insurance (n=480; 29%) were the most common forms of insurance, followed by self-pay (n=357; 22%). The majority of triage codes for ED visits were nonurgent (n=140; 93%). Twenty-five patients (17%) were not referred for follow-up upon ED discharge. Adolescents on public assistance or without insurance may frequently utilize an urban ED for nonurgent medical problems. A group of patients did not identify a primary care provider at triage and were not referred for follow-up. Defining medical problems for which adolescents utilize the ED may help health professionals to tailor community resources to better serve adolescent health care needs.


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