6515 Maternal and child determinants of paediatric low acuity emergency department attendances in a London hospital: a data linkage study

Objectives Low acuity emergency department (ED) attendances (LAA) in children, typically those not requiring admission, medication or other treatment, are an increasing challenge.1 National data shows significant geographical variation in paediatric ED attendances,2 and social determinants of health vary by region. Local data on associations of LAA is crucial to inform strategies to reduce such attendances. We aim to examine associations between child and maternal factors (collected antenatally at booking appointment) with LAA in children in a London hospital. Methods ED attendances in a pre-pandemic cohort of children aged and assigned one of five diagnoses: 'Neonatal feeding difficulties', 'No problem identified', 'Not a specified problem', 'Paediatric parental concern' and 'Worried anxious parents, no problem' Logistic regression analysis was performed on pseudonymised data to explore associations of LAA. Ethics approval ref:SE22/016. Results Of 8487 ED attendances during the study period, 4686/8487 (55%) were successfully linked via NHS numbers to maternal records (limited to those children who were born in the same hospital). The median age of children was 1.2yrs, 46.5% were the first child and 55.4% were male. The median age of Mothers was 29, 7.1% reported mental health problems, 1.6% had a social worker and 3.9% were smokers. After omitting attendances with missing diagnoses, 369/4331 (8.5%) were LAA. Multivariable analysis showed that younger child age (pConclusion To our knowledge, this is the first study using linked antenatal data to explore associations of LAA, a potentially replicable methodology. Limitations were the relatively low rates of successful linkage and missing data. LAA association with younger child age and lower parity is consistent with existing literature. To the best of our knowledge, the is the first study demonstrating an association with maternal smoking status. Reducing LAA requires strengthening primary care access and supporting families in the antenatal and postnatal period in the local area. Supported by these data, funding has been secured for the Optivita project, (https://www.harrowbbp.nhs.uk/) aiming to improve preventative care in socially disadvantaged localities. References Alele FO, Emeto TI, Callander EJ, Watt K. Non-urgent paediatric emergency department presentation: A systematic review. Journal of Paediatrics and Child Health, 2019. Nath S, Zylbersztejn A, Viner RM, Cortina-Borja M, Lewis KM, Wijlaars L, et al. Determinants of accident and emergency attendances and emergency admissions in infants: birth cohort study. BMC Health Serv Res, 2022.