Evidence map›Paper›PMID 40197168›Full record

ArticleBMC pediatrics2025

Avoidable visits to the paediatric emergency department: associated factors and lessons learned from the pandemic.

João Viana, João Vasco Santos, Andreia Pinto, Almeida Santos, Alberto Freitas

Abstract read
In one paragraph

Article in BMC pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

João VianaMEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal. joaoviana@med.up.pt.ORCID https://orcid.org/0000-0002-2057-6109
João Vasco SantosMEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.ORCID https://orcid.org/0000-0003-4696-1002
Andreia PintoMEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.ORCID https://orcid.org/0000-0001-7226-2112
Almeida SantosServiço de Pediatria / Urgência Pediátrica, UAG da Mulher e da Criança, Centro Hospitalar Universitário de São João, Porto, Portugal.
Alberto FreitasMEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.ORCID https://orcid.org/0000-0003-2113-9653

Funding

Fundação para a Ciência e Tecnologia PD/BD/129833/2018
6 · The paper itself

Abstract

purposeThe main goal of this study is to identify the associated factors with avoidable admissions in ED, comparing pre-COVID and COVID periods.

methodsThis was retrospective study that took place in a Paediatric Emergency Department of a metropolitan, university-affiliated hospital in Portugal. All visits to paediatric emergency department between 2014 and 2020 were considered.

resultsThere was a decrease of 7.2% points in avoidable visits between pre-COVID and COVID periods. Considering both periods, this study identifies older ages, being admitted to the paediatric emergency department between 4 and 7 a.m., referral and having visited the emergency department previously within 72 h as major factors associated with a reduced likelihood for avoidable visits. On the other hand, it identifies an increased likelihood of avoidable visits in the 3 to 5 years old age group, visits that occurred during the Summer and visits that occurred between 8 and 11 p.m. When considering what changed between pre-COVID and COVID periods, while having visited the paediatric emergency department 72 h prior made it less likely for the patient to be an avoidable visit during the pandemic period, this tendency has inverted, making it more likely for return visits to be avoidable.

conclusionsThe relatively low decrease in avoidable visits' ratios between pre-COVID and COVID periods, associated with the similar distribution of attendance during the day and lower odds ratio of avoidable visits during periods when primary care is available, suggests that avoidable visits are a chronical problem of the National Health system's structure and its usage, not having a single factor nor a combination of factors as a driving force. Nevertheless, this study identified several factors associated with avoidable visits to the emergency department. Therefore, it can aid policy makers to create targeted interventions to mitigate this problem.

Indexed as

COVID-19Emergency Service, HospitalAdolescentChildChild, PreschoolFemaleHumansInfantMalePandemicsPortugalRetrospective StudiesAssociated factorsAvoidable admissionsCOVID-19Emergency departmentHealthcare utilizationPaediatric patients

Identifiers

PMID40197168
PMCPMC11974229

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.