The impact of low socioeconomic status and primary health care access on emergency department presentations in young children in regional Queensland

The impact of low socioeconomic status and primary health care access on emergency department presentations in young children in regional Queensland

Aim
The purpose of this study was to empirically evaluate if children from low socio-economic status (SES) families in regional southeast Queensland utilise acute care services for low acuity health care rather than utilising primary health services.

Methods
A retrospective audit of children under the age of 5 years presented at a regional hospital emergency department (ED) over a 12-month period. Medical records were examined for presenting problem, Australasian triage category, care outcomes, whether the child's parent/guardian held an Australian concession/health care card (AC/HCC) and accessed child health services or a general medical practitioner (GP).

Results
Eight hundred and eighty-eight children who had not reached their fifth birthday presented to ED between 1 June 2019 and 31 May 2020, with a total of 1691 presentations. Most children were bought to the ED by their parents with semi-urgent health concerns and were discharged home following medical review. Holding an AC/HCC was a significant predictor for hospital presentation. Holding an AC/HCC was not associated with access to child health services. However, accessing child health services resulted in a small but significant increase in hospital presentations.

Conclusions
The AC/HCC may be an important proxy to identify low SES individuals. These card holders tended to use acute services more frequently than those who did not qualify for an AC/HCC. Furthermore, families that engage with primary care services such as child health also accessed acute care services more frequently. The results indicate accessing primary health-care services does not ameliorate the use of acute care services.