Adolescent consultations at the peadiatrics emergency service

Abstract

The WHO defines an adolescent as any person between ages 10 and 19 (early adolescence being between 10 and 14 years old, late adolescence being between 15 and 19 years). The prevalence of diseases in adolescents is low, although they use the emergency services and thus require a comprehensive and multidisciplinary approach. No data has been published on the reasons for the consultation of adolescents in Uruguay.
Objective: the aim of this study was to determine the frequency and characteristics of adolescent consultations at the emergency services in the public and private subsector of the national integrated health system.
Method: multicenter, retrospective study of adolescents between ages 10 and 14 years old who consulted at the Pereira Rossell Hospital HP-CHPR (public sector) and between 10 and 19 years old in AE, CAMOC, CG (private sector). The study included consultations from 7th to 13th January, April, July and October 2013, and the following data were recorded: age, sex, chief complaint, comorbidities, specialist consultations, laboratory tests, diagnosis and destination upon discharge. Statistical analysis was performed, being p <0.05 statistically important. Results: n = 1518, representing 9% of all consultations. Age: mean 13 years 1 month, male: 50.5%; comorbidities: 26%. Public sector 35%; private sector: 65%. Distribution of consultations per month: January 20%, April 30%, May 20%, October 30%. The most frequent reasons for consultation were lesions and injuries 33%, respiratory symptoms 14%, other 13%, 12.5% gastrointestinal symptoms, skin lesions 7%. Psycho-social problems represented 7.2% in the public sector and 3.2% in the public sector. Consultation with a specialist 38%; laboratory: 16%; imaging techniques 30%. Main diagnoses upon discharge: 33% trauma, 20% respiratory disease, 13% other, 10% gastrointestinal pathology, 6.6% pathology of skin 6,6%. Final destination: 90% home, 13% hospital in the public sector, 8% hospital in the private sector, 0.9% leave the emergency service before assistance, 0.1% institutionalized.
Conclusions: while adolescent consultation has a low prevalence, it has a significant impact on emergency services due to its use of resources. Differences are observed between the public and private sector.