Factors associated with non-urgent presentations in the paediatric emergency department using Andersen's behavioural model: A cross-sectional descriptive study

Abstract

Objectives: To explore the rate of NUPs and associated factors in the PED of the ‘Hospital Universitario y Politécnico La Fe’ in Valencia (Spain) using Andersen's Behavioural Model. Methods: We conducted a descriptive cross-sectional study using Andersen's Behavioural Model in parents visiting the PED with their children at the ‘Hospital Universitario y Politécnico La Fe’ in Valencia (Spain). Results: The study involved a total of 530 participants, of whom 419 (79%) had made an NUP. The predisposing factors identified were: (I) paediatric patients brought in by their fathers (OR = 0.460; p= 0.005), (II) lower educational attainment (OR = 3.841; p= 0.000), (III) first-time parenthood (OR = 2.335; p= 0.000) and (IV) higher parental stress (OR = 1.974; p= 0.023). The enabling factors included: (I) responsibility for a significant part of the childcare shared with others (OR = 0.348; p= 0.041) and (II) the perception that PEDs provide better care than primary care (PC) services (OR = 1.628; p= 0.005). The need factors were: (I) existing chronic illness in the child seeking care (OR = 0.343; p= 0.000) and (II) the perceived severity of the urgency (OR = 0.440; p= 0.031). Conclusions: The NUP rates found in this study are similar to those found interna tionally. In accordance with Andersen's Behavioural Model, we identify predisposing, enabling and need factors to explain the multifactorial nature of NUPs in PEDs. Implications for Practice: Identifying the factors associated with NUPs enables interven tions to be targeted at those groups most likely to engage in NUPs, thereby optimising the functioning of the PED and improving the well-being of children and families. These interventions should focus on improving parental health literacy, providing education on making appropriate decisions about accessing health services and recognising severe symptoms in children, as well as improving access to high-quality PC services. Providing support to parents during the transition to parenthood would also be beneficial. Reporting Method: This paper adheres to the STROBE initiative guidelines. Contribution from patients or members of the public: Participants, who voluntarily agreed to take part, contributed to the study by completing a paper-based questionnaire containing all the study variables as prepared by the research team.