Children in disadvantaged neighbourhoods have more out-of-hospital emergencies: a population-based study. Issue 11 (2nd May 2018)

• Record Type: Journal Article
• Authors: Salmi, Heli; Kuisma, Markku; Rahiala, Eero; Lääperi, Mitja; Harve-Rytsälä, Heini
• Is Part Of: Archives of disease in childhood. Volume 103:Issue 11(2018)
• Page Start: 1048
• Page End: 1053
• Publication Date: 2018-05-02
• Subjects: epidemiology -- health services research; Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2017-314153
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : 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.