RT Journal Article
SR Electronic
T1 Children in disadvantaged neighbourhoods have more out-of-hospital emergencies: a population-based study
JF Archives of Disease in Childhood
JO Arch Dis Child
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP 1048
OP 1053
DO 10.1136/archdischild-2017-314153
VO 103
IS 11
A1 Heli Salmi
A1 Markku Kuisma
A1 Eero Rahiala
A1 Mitja Lääperi
A1 Heini Harve-Rytsälä
YR 2018
UL http://adc.bmj.com/content/103/11/1048.abstract
AB Objective We wanted to study whether the socioeconomic status of a neighbourhood can predict the incidence of paediatric out-of-hospital emergencies.Methods We conducted a population-based prospective study with all paediatric (0–15 years) out-of-hospital emergencies in Helsinki, Finland, in 2012–2013. We compared the geographical distribution of the emergencies in the paediatric population with those of mean income, unemployment level and educational level. The comparison was made both by the scene of the emergency and by the domicile of the patient. We also separately analysed the distribution of emergency medical (EM) contacts that were deemed medically unnecessary.Results The incidence of out-of-hospital emergencies was higher in areas with lower socioeconomic status and among children living inside those areas. Higher mean income was associated with lower incidence (risk ratio (RR) 0.970, 95% CI 0.957 to 0.983), and lower unemployment level to higher incidence (RR 1.046, 95% CI 1.002 to 1.092) of out-of-hospital emergencies inside a district. Higher mean income was associated with lower incidence of emergencies in the paediatric population living inside a district (RR 0.983, 95% CI 0.974 to 0.993). The distribution of medically unnecessary EM contacts was similar in all areas.Conclusions The socioeconomic status of a neighbourhood was associated with the need for EM services (EMS) in the area, and in children living in the area. Overusing EMS for non-urgent or non-medical problems did not explain these findings. Instead, they seem to represent true differences in the incidence of paediatric emergencies.