In this study, in which all patients under the age of 18, who applied to the hospital PES, were examined by using data obtained from the data processing center of a foundation university hospital in Ankara 6550 paediatric patients (with the first 15 diagnoses seen the most) out of a total of 16.383 patients were included in the study.
Although it is stated that there are deficiencies in the hospital registry system from which patient data is obtained, it is still the most reliable system. (13.14.15)
A significant portion of the applications in the study were non-emergency patients (81%), and there were no patients in the "very urgent" category (0%). Although the results coincide with the findings of the studies in the literature, the rate of “non-emergency patients” is higher, and there is no application in the “very urgent patient” group.
The rate of emergency triage status (20.1%) of male patients, who applied to PES, is higher than that of women. The top three most common diagnoses are: "Fever of unknown cause", "Cough" and "Nausea and vomiting".
When the differences according to gender are examined, while there is no difference in the first three diagnoses "Fever of unknown cause", "Cough" and "Nausea and vomiting", women and girls have higher diagnoses of "Abdominal and pelvic pain" and "Acute tonsillitis" than men; the diagnoses of 'Falls, unspecified' and 'Other non-infective gastroenteritis and colitis' are also higher in men.
When we look at the distribution of diagnoses; while “Soft tissue injury” constituted the majority of the reasons for applying to PES in Erzurum in the study of Polat et al., there were Fever (22%), Cough (16%) and Nausea-vomiting (10%) in the first three places in the study of Karakaş et al. that they did in Ankara. It was observed in this study made in Ankara that the first three most common diagnoses were "Fever of unknown cause" (28%), "Cough" (18%) and "Nausea and vomiting" (9%) respectively. Accordingly, while the diagnoses of admission to the PES in the same region are similar, they differ in different regions. (2, 16)
When we look at the distribution of application rates by age group; in the study of Karakaş et al.; the least application was with 2% in the neonatal period (0–28 days) and with 66% between the ages of 1 month and 6 years. In this study, the age group of 0–28 days applied the least with 5.4%, the pre-school period, which is 19 months-5 age group, applied the most with 49.1%. These results in the two studies are similar. (2)
Another finding obtained in the study is that there is a relationship between the age group of the patients and their triage codes. It was observed in the study that the patients between 0–28 days was the least applied group with 5%, besides they had the highest emergency triage status with 66.5% and that the age group of 19 months-5 with the highest number of applications with 49% had the lowest emergency triage rate with 12.8%. We can associate this situation with the fact that families do not apply during the new-born period unless there are situations that we can describe as real emergencies and/or they do not experience a process that requires them to apply to the emergency in this age group. Similarly, we can say that families of the preschool period, which is 19 months-5 years, apply to emergency services in almost every complaint of their children, although it is not considered urgent and/or they go through the process that makes them think about applying to the emergency department in this age group.
When the differences according to gender in application to PES are examined in the study of Polat et al.; soft tissue injury with 62%, intoxication with 75%, and burns with 63% are more frequent in males; foreign body aspiration with 66.7% is more frequent in females. While there was no difference in terms of gender in the first three most common diagnoses in this study, whereas women were higher in "Abdominal and pelvic pain" and "Acute tonsillitis" diagnoses; the proportion of males were higher in the diagnoses of "falls, unspecified" and "other non-infective gastroenteritis and colitis”.
Looking at the consultation rates, consultation was requested for 0.27% of the patients in the study of Çevik et al., which included all emergency department (adult and children) patients, and 12.5% of the patients in Yüksel's study, which included only adults (over 18 years old) emergency applications, (14) consultation was requested for 3.2% in this study.
In the study of Polat et al., 97% of the patients were discharged and 3% were hospitalized. In the study of Karakaş et al.; while 49% of the patients were prescribed and underwent outpatient treatment, 48% were sent with recommendations without prescription, and approximately 2% of the patients were hospitalized in service and intensive care. (2, 16)
According to the findings obtained in this study, 95% (n = 6211) of the patients were not prescribed a recipe, and 5% (n = 339) were prescribed. One diagnosis was made for 85% of the patients (n = 5584), two for 13.8% (n = 901), three for 0.9% (n = 58) and four for 0.1% (n = 7). 4% (n = 238) of the patients were hospitalized. There is no patient who underwent surgery. Hospitalization rates are similar to the literature.
This research data is limited to the 2018 data of a Foundation University hospital in Ankara. These results may differ in smaller residential units or in public health units PES. Moreover, it should be noted that there might be differences in results due to the Covid-19 pandemic process in 2020.