Journal of Pediatrics
Volume 170, 2016, Pages 218-226

Emergency Department Revisits by Urban Immigrant Children in Canada: A Population-Based Cohort Study (Article)

Saunders N.R. , To T. , Parkin P.C. , Guttmann A.*
  • a Division of Pediatric Medicine, Hospital for Sick Children, Toronto, Canada, Department of Pediatrics, University of Toronto, Toronto, Canada, Institute of Health Policy, Management and Evaluation, University of Toronto, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada, Institute for Clinical Evaluative Sciences, Toronto, Canada
  • b Institute of Health Policy, Management and Evaluation, University of Toronto, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada, Institute for Clinical Evaluative Sciences, Toronto, Canada, Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Canada, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
  • c Division of Pediatric Medicine, Hospital for Sick Children, Toronto, Canada, Department of Pediatrics, University of Toronto, Toronto, Canada, Institute of Health Policy, Management and Evaluation, University of Toronto, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada, Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Canada, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
  • d Division of Pediatric Medicine, Hospital for Sick Children, Toronto, Canada, Department of Pediatrics, University of Toronto, Toronto, Canada, Institute of Health Policy, Management and Evaluation, University of Toronto, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada, Institute for Clinical Evaluative Sciences, Toronto, Canada, Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Canada, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada

Abstract

Objectives To examine the relationship between family immigrant status and unscheduled 7-day revisits to the emergency department (ED) and to test this relationship within subgroups of immigrants by visa class (family, economic, refugee), native tongue on landing in Canada, and region of origin. Study design Population-based cohort study that used multiple linked health administrative and demographic datasets of landed immigrant and nonimmigrant children (<18 years) in urban Ontario who visited an ED and were discharged between April 2003 and March 2010. Logistic regression was used to model the odds of 7-day ED revisits with family immigrant status, with adjustment for patient and ED characteristics. Results Of 3 322 901 initial visits to the ED, 249 648 (7.5%) resulted in a 7-day revisit. There was no significant association of immigrant status with either ED revisits or poor revisit outcomes (greater acuity visit or need for admission) in the adjusted models. Within immigrants, the odds of revisit were not associated with immigrant classes or region of origin; however, immigrants whose native tongue was not English or French had a slightly greater odds of revisiting the ED (aOR 1.05; 95% CI 1.01, 1.09). Significant predictors of revisits included younger age, greater triage acuity score, greater predilection for using an ED, daytime shifts, and greater deprivation index. Conclusions Immigrant children are not more likely to have short-term revisits to the ED, but there may be barriers to care related to language fluency that need to be addressed. These findings may be relevant for improving translation services in EDs. © 2016 Elsevier Inc.

Author Keywords

[No Keywords available]

Index Keywords

urban population Communication Barriers immigrant refugee English (language) human epidemiology communication disorder sex difference Cohort Studies statistics and numerical data controlled study priority journal Logistic Models language school child social status migrant Humans Adolescent Infant, Newborn Canada male preschool child Emigrants and Immigrants Infant Child, Preschool newborn female high risk population population research work schedule Article Retrospective Studies health care utilization Ontario major clinical study emergency care hospital readmission emergency health service age Age Factors child hospitalization utilization patient acuity low volume hospital correlational study cohort analysis Emergency Service, Hospital French (language) statistical model social class retrospective study health care need Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84960340213&doi=10.1016%2fj.jpeds.2015.11.037&partnerID=40&md5=b5e725a6bba0454300ae1547c8ca7bc1
DOI: 10.1016/j.jpeds.2015.11.037
ISSN: 00223476
Cited by: 10
Original Language: English