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Health Care Access Barriers Bring Children to Emergency Rooms More Frequently: A Representative Survey

机译：一项代表性调查显示，医疗保健进入壁垒将儿童更频繁地带到急诊室

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Children may visit the emergency department (ED) regularly in part because they and their caregivers may be experiencing barriers to appropriate and timely pediatric care. However, assessing the wide range of potential barriers to access to care that children and their caregivers may experience is often a challenge. The objective of this study was to assess the barriers to pediatric health care reported by caregivers and to examine the association between those reported barriers to care with the frequency of children's ED visits in the past 12 months. Assessment of ED utilization and access to care barriers was made through a telephone interview survey conducted as part of a broader Community Health Needs Assessment in 2015. A weighted community sample of adult caregivers (N = 1057) of children between the ages of 0-17 residing in Miami-Dade, Broward, and Palm Beach counties, Florida were contacted. This study found that multiple ED visits (= 2 vs. 0) in the past 12 months by a child were most strongly associated with access to care barriers attributed to language and culture (relative risk [RR] = 2.51), trouble finding a doctor (RR = 1.86), scheduling an appointment (RR = 1.68), and transportation access (RR = 1.73). These findings suggest that access to care barriers experienced by households may exacerbate the risk of a child experiencing repeated visits to the ED in a year. Findings are discussed further in the context of actionable population health management strategies to reduce risk of frequent ED utilization by children.
机译：儿童可能会定期去急诊室（ED），部分原因是他们和他们的看护人可能会遇到障碍，无法及时获得适当的儿科护理。然而，评估儿童及其照顾者可能遇到的各种潜在的获得医疗的障碍通常是一个挑战。这项研究的目的是评估护理人员报告的儿科保健障碍，并检查过去12个月儿童报告的ED就诊频率与这些报告的障碍之间的关联。 ED的利用和获得护理障碍的评估是通过电话采访调查进行的，该调查是2015年进行的更广泛的社区健康需求评估的一部分。加权的成人成年看护人（N = 1057）儿童样本范围为0-17岁联系了居住在佛罗里达州迈阿密戴德县，布劳沃德县和棕榈滩县的居民。这项研究发现，在过去的12个月中，儿童多次就诊（> = 2 vs. 0）与语言和文化所致的医疗障碍的获取密切相关（相对风险[RR] = 2.51），难以找到医生（RR = 1.86），安排约会（RR = 1.68）和交通服务（RR = 1.73）。这些发现表明，家庭遇到的护理障碍可能会加剧儿童一年内再次探访急诊室的风险。在可行的人群健康管理策略中进一步讨论了发现，以减少儿童频繁使用ED的风险。

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