6329 Patterns in the frequency of visits to the paediatric emergency department made over the past three years

Objectives This study identified the number of previous admissions for 100 patients visiting the paediatric emergency department in Leicester Royal Infirmary over the past three years. This was to better understand any patterns in attendance, especially in patients who visit frequently. Methods Data were collected over five consecutive days in July 2023. Admissions were categorised: infection, injury, mental health, chronic condition or other. Electronic patient records were accessed to identify each patient's hospital number, age at admission, and number and reasons for previous visits. 11% of patients were under the age of 3. Results Infections were the biggest cause for admission with 36.1%, injuries and chronic conditions following at 31.5% and 10.2% respectively. 6.5% of admissions were related to mental health conditions. Upper respiratory tract infections caused the most admissions categorised as infection with 29.3%, followed by infective gastroenteritis causing 22.0%. 75% of patients had fewer than three previous visits. 27 patients had two previous visits, the most frequent number. The second most common number of previous visits was one. As the number of previous visits increased, the frequency of patients decreased. The highest number of visits by a single patient was 39, most due to mental health. 6% of patients had visited 10 or more times, making up 32.7% of the total visits made by all patients in the study period. These frequent visits were mostly for recurrent infections secondary to chronic illnesses, and mental health issues, including overdoses. 5% of the patients admitted had an admission due to an overdose in the last 3 years. Conclusion Since a high number of patients with multiple admissions had chronic illnesses, including mental health conditions, more detailed care planning and early interventions are required to reduce the number of patients who require admission. Strategies to provide care earlier should be made available to avoid patients with these diagnoses needing to visit. Some of the patients admitted due to upper respiratory tract infections could have been seen in primary care and avoided admission, highlighting the importance of access to primary care, and educating carers when accident and emergency is required. Having prompt follow-up appointments and involving carers when forming care plans could reduce patients presenting multiple times for a single issue as it would allow all parties to understand the issues fully, and feel confident in the care.