Background
Methods
Population
Data source
Outcomes
Analyses
Results
Population characteristics and healthcare use
Total | One-year emergency department visit | Overall age | |||||
---|---|---|---|---|---|---|---|
No | At least one | 1 | 2 | ≥3 | Median IQR | ||
N (million) | 13.211 | 10.096 | 3.115 | 2.131 | 0.615 | 0.369 | |
% row | 100.0 | 76.4 | 23.5 | 16.1 | 4.7 | 2.8 | |
N ED visits (million) | 4,805 | 0 | 4,805 | 2,131 | 1,230 | 1,444 | |
% row | 100.0 | 44.3 | 25.6 | 30.1 | |||
% | % | % | % | % | % | ||
Age | - | ||||||
0 - < 1 year | 5.1 | 3.9 | 9.1 | 7.1 | 10.9 | 17.7 | - |
1 - < 2 | 5.3 | 4.2 | 8.8 | 7.4 | 10.4 | 14.0 | - |
2 - < 5 | 16.4 | 15.2 | 20.3 | 19.6 | 21.5 | 21.8 | - |
5 - < 10 | 28.4 | 29.9 | 23.7 | 25.7 | 21.5 | 16.1 | - |
10 - < 14 | 22.7 | 23.8 | 18.9 | 20.1 | 17.6 | 14.4 | - |
14 - < 18 | 22.1 | 23.0 | 19.2 | 20.1 | 18.2 | 16.0 | - |
Median [IQR] | 9 [4–13] | 9 [5–13] | 7 [2–12] | 8 [3–12] | 6 [2–12] | 4 [1–11] | - |
Gender | |||||||
Girls | 48.8 | 49.4 | 47.1 | 46.8 | 47.1 | 48.8 | 9 [4–13] |
Boys | 51.2 | 50.6 | 52.9 | 53.2 | 52.9 | 51.2 | 9 [4–13] |
CMUc | 17.5 | 16.0 | 22.7 | 20.6 | 24.7 | 31.4 | 8 [4–12] |
No CMUc | 82.4 | 83.9 | 77.1 | 79.2 | 75.2 | 68.5 | 9 [4–13] |
Missing | 0.1 | 0.1 | 0.2 | 0.2 | 0.1 | 0.1 | |
FDep deprivation index (quintile) | |||||||
1 (less deprived) | 19.5 | 20.4 | 16.6 | 17.3 | 15.8 | 14.2 | 9 [4–13] |
2 | 20.0 | 20.4 | 18.7 | 19.2 | 18.1 | 16.9 | 9 [4–13] |
3 | 19.6 | 19.5 | 20.1 | 20.1 | 20.2 | 20.3 | 9 [4–13] |
4 | 19.5 | 19.2 | 20.5 | 20.4 | 20.7 | 20.7 | 9 [4–13] |
5 (most deprived) | 20.1 | 19.3 | 23.0 | 22 | 24.2 | 27.0 | 9 [4–13] |
Missing | 1.1 | 1.1 | 1.1 | 1.1 | 1.1 | 1.0 | |
Municipality of residence | |||||||
Urban | 77.5 | 77.0 | 79.4 | 78.5 | 80.2 | 82.9 | 8 [4–13] |
Rural | 21.8 | 22.4 | 20.0 | 20.9 | 19.2 | 16.6 | 9 [5–13] |
Missing | 0.6 | 0.7 | 0.6 | 0.6 | 0.6 | 0.5 | |
ED in the municipality residence | |||||||
Yes | 29.5 | 28.3 | 33.3 | 31.9 | 34.8 | 39.0 | 8 [4–13] |
No | 69.5 | 70.6 | 65.8 | 67.2 | 64.3 | 60.2 | 9 [4–13] |
Missing | 1 | 1 | 1 | 1 | 0.9 | 0.8 | |
Total | |||||||
At least one LTD | 4.0 | 3.5 | 5.3 | 4.6 | 5.8 | 8.8 | 10 [6–14] |
No LTD | 96.0 | 96.5 | 94.7 | 95.4 | 94.2 | 91.2 | 8 [4–13] |
Boys | |||||||
At least one LTD | 4.6 | 4.2 | 5.8 | 5.2 | 6.3 | 9.1 | 10 [6–14] |
No LTD | 95.4 | 95.8 | 94.2 | 94.8 | 93.7 | 90.9 | 8 [4–13] |
Girls | |||||||
At least one LTD | 3.3 | 2.9 | 4.8 | 4.0 | 5.3 | 8.4 | 11 [7–14] |
No LTD | 96.7 | 97.1 | 95.2 | 96.0 | 94.7 | 91.6 | 9 [4–13] |
10 most frequent LTD (ICD-10): | |||||||
Pervasive developmental disorders | 0.53 | 0.52 | 0.56 | 0.53 | 0.58 | 0.68 | 10 [7–13] |
Asthma | 0.24 | 0.19 | 0.39 | 0.30 | 0.44 | 0.80 | 9 [5–13] |
Specific developmental disorders of speech and language | 0.17 | 0.17 | 0.19 | 0.18 | 0.19 | 0.21 | 10 [7–13] |
Epilepsy | 0.17 | 0.13 | 0.28 | 0.21 | 0.32 | 0.62 | 11 [7–14] |
Unspecified mental retardation | 0.16 | 0.15 | 0.18 | 0.17 | 0.19 | 0.25 | 11 [7–14] |
Type 1 diabetes mellitus | 0.15 | 0.12 | 0.25 | 0.23 | 0.28 | 0.34 | 12 [9–15] |
Scoliosis | 0.15 | 0.16 | 0.13 | 0.13 | 0.12 | 0.13 | 15 [13–16] |
Specific developmental disorders of scholastic skills | 0.12 | 0.12 | 0.13 | 0.12 | 0.13 | 0.14 | 11 [9–14] |
Mixed disorders of conduct and emotions | 0.10 | 0.09 | 0.13 | 0.11 | 0.13 | 0.20 | 12 [9–14] |
Mixed specific developmental disorders | 0.09 | 0.08 | 0.10 | 0.1 | 0.12 | 0.13 | 10 [7–13] |
One-year emergency department visit | ||||||
---|---|---|---|---|---|---|
Total | No | At least one | 1 | 2 | ≥ 3 | |
N children (million) | 13,211 | 10,096 | 3,115 | 2,131 | 0,615 | 0,369 |
% | % | % | % | % | % | |
Primary care consultationa | ||||||
GPP (%)a | 88.0 | 86.7 | 92.3 | 91.4 | 93.6 | 95.4 |
Median [IQR] | 3 [2–6] | 3 [2–5] | 4 [2–8] | 4 [2–7] | 5 [3–8] | 6 [3–11] |
GP (%)a | 83.6 | 82.2 | 88.0 | 87.1 | 89.3 | 91.0 |
Median [IQR] | 3 [2–5] | 3 [1–5] | 4 [2–6] | 3 [2–6] | 4 [2–7] | 5 [3–9] |
Paediatrician (%)a | 17.3 | 15.6 | 22.6 | 20.5 | 24.8 | 31.3 |
Median [IQR] | 2 [1–4] | 2 [1–4] | 3 [1–6] | 2 [1–5] | 3 [1–6] | 4 [2–8] |
Nurse (%)a | 8.1 | 6.4 | 13.6 | 12.2 | 15.5 | 18.7 |
Median [IQR] | 1 [1, 2] | 1 [1, 2] | 1 [1–4] | 1 [1–3] | 1 [1–5] | 2 [1–6] |
Physiotherapist (%)a | 7.1 | 5.7 | 11.4 | 9.7 | 13.1 | 18.3 |
Median [IQR] | 8 [4–15] | 8 [4–15] | 8 [4–15] | 8 [4–15] | 7 [4–14] | 7 [4–15] |
Dentist (%)a | 37.3 | 39.0 | 31.8 | 33.7 | 29.7 | 24.4 |
Median [IQR] | 1 [1, 2] | 1 [1, 2] | 1 [1, 2] | 1 [1, 2] | 1 [1, 2] | 1 [1, 2] |
Specialists (except paediatrician (%)a | 39.5 | 39.2 | 40.3 | 40.2 | 40.6 | 40.5 |
Median [IQR] | 1 [1, 2] | 1 [1, 2] | 1 [1, 2] | 1 [1, 2] | 1 [1, 2] | 1 [1, 2] |
Ophthalmologista | 24.7 | 25.3 | 23.0 | 23.6 | 22.4 | 20.4 |
Dermatologista | 7.1 | 7.3 | 6.5 | 6.6 | 6.3 | 5.8 |
ENTa | 7.0 | 6.5 | 8.7 | 8.2 | 9.4 | 10.8 |
Surgeona | 4.2 | 3.5 | 6.5 | 6.0 | 7.4 | 8.1 |
Cardiologista | 1.2 | 1.1 | 1.6 | 1.5 | 1.7 | 2.2 |
Pneumologista | 1.2 | 1.1 | 1.4 | 1.3 | 1.5 | 1.8 |
Psychiatrista | 1.0 | 1.0 | 1.2 | 1.1 | 1.2 | 1.4 |
Outpatient consultationa | ||||||
GP or paediatrician (%)a | 8.5 | 5.0 | 19.9 | 17.4 | 22.8 | 29.1 |
GP (%)a | 5.6 | 2.9 | 14.1 | 13.1 | 15.9 | 17.0 |
Paediatrician (%)a | 3.1 | 2.2 | 6.4 | 4.73 | 7.6 | 13.7 |
Hospitalisationa | ||||||
SSH | 8.8 | 4.84 | 21.5 | 16.2 | 26.93 | 42.51 |
Median [IQR] | 1 [1–1] | 1 [1–1] | 1 [1–1] | 1 [1–1] | 1 [1–1] | 1 [1, 2] |
SSH after ED visit | 3.4 | 14.3 | 9.5 | 19.1 | 34.0 | |
Paediatric Intensive care | 0.10 | 0.03 | 0.30 | 0.16 | 0.39 | 0.95 |
Neonatology | 0.60 | 0.35 | 1.30 | 0.88 | 1.58 | 3.26 |
Neonatology with intensive care | 0.20 | 0.12 | 0.49 | 0.31 | 0.60 | 1.37 |
Psychiatric hospitalisation | 0.3 | 0.22 | 0.59 | 0.41 | 0.69 | 1.49 |
Hospitalisation at home | 0.2 | 0.19 | 0.35 | 0.07 | 0.14 | 0.63 |
Rehabilitation care | 0.0 | 0.02 | 0.11 | 0.29 | 0.41 | 0.32 |
ED visits
Odds ratio (95% CI) | Odds ratio adjusted by age and gender (95% CI) | Odds ratio adjusted Full model (95% CI) | |
---|---|---|---|
Age (Years) | |||
< 1 | 2.84 [2.82–2.85] | 2.85 [2.84–2.87] | |
1 | 2.49 [2.47–2.50] | 2.47 [2.46–2.49] | |
2–4 | 1.60 [1.59–1.60] | 1.58 [1.57–1.59] | |
5–9 | 0.95 [0.94–0.95] | 0.94 [0.94–0.94] | |
10–13 | 0.95 [0.95–0.95] | 0.95 [0.94–0.95] | |
14–17 | 1 | 1 | |
Gender | |||
Boys | 1 | 1 | |
Girls | 0.91 [0.91–0.91] | 0.92 [0.91–0.92] | |
CMUc vs none | 1.55 [1.55–1.56] | 1.52 [1.51–1.52] | 1.45 [1.44–1.45] |
FDep deprivation index (quintile) | |||
1 (less deprived) | 1 | 1 | |
2 | 1.12 [1.12–1.13] | 1.13 [1.12–1.13] | |
3 | 1.27 [1.26–1.27] | 1.28 [1.28–1.29] | |
4 | 1.31 [1.30–1.31] | 1.33 [1.32–1.33] | |
5 (most deprived) | 1.47 [1.46–1.48] | 1.49 [1.48–1.49] | |
Commune type | |||
Urban | 1 | 1 | 1 |
Rural | 0.87 [0.87–0.87] | 0.89 [0.89–0.89] | 0.99 [0.99–0.99] |
ED in the commune of residence vs no | 1.26 [1.26–1.27] | 1.23 [1.23–1.24] | 1.15 [1.15–1.15] |
At least one LTD vs no | 1.53 [1.52–1.54] | 1.70 [1.69–1.72] | |
LTD | |||
Pervasive developmental disorders | 1.06 [1.04–1.08] | 1.21 [1.19–1.23] | 1.08 [1.06–1.10] |
Asthma | 2.06 [2.01–2.11] | 2.23 [2.18–2.28] | 2.04 [1.99–2.09] |
Specific developmental disorders of speech and language | 1.11 [1.08–1.14] | 1.30 [1.27–1.34] | 1.17 [1.13–1.20] |
Epilepsy | 2.16 [2.11–2.22] | 2.45 [2.39–2.52] | 2.13 [2.07–2.19] |
Unspecified mental retardation | 1.20 [1.16–1.24] | 1.39 [1.35–1.43] | 1.12 [1.09–1.16] |
Type 1 diabetes mellitus | 2.08 [2.02–2.14] | 2.49 [2.42–2.56] | 2.39 [2.32–2.46] |
Scoliosis | 0.80 [0.77–0.83] | 1.00 [0.96–1.03] | 0.97 [0.94–1.01] |
Specific developmental disorders of scholastic skills | 1.11 [1.07–1.15] | 1.34 [1.30–1.39] | 1.20 [1.16–1.24] |
Mixed disorders of conduct and emotions | 1.38 [1.33–1.43] | 1.65 [1.59–1.72] | 1.43 [1.38–1.49] |
Mixed specific developmental disorders | 1.26 [1.21–1.31] | 1.45 [1.39–1.51] | 1.26 [1.21–1.31] |
Congenital malformations of cardiac septa | 1.60 [1.54–1.67] | 1.55 [1.49–1.61] | 1.32 [1.27–1.38] |
At least one other LTD | 1.68 [1.67–1.69] | 1.81 [1.80–1.83] | 1.72 [1.70–1.73] |
GP or paediatrician visit before an ED visit
Total | Age (years) | CMUc | FDep | LTD | ED in the commune of residence | ED visit | |||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
< 1 | 1 | 2–4 | 5–9 | 10–13 | 14–17 | Yes | No | 1 | 2 | 3 | 4 | 5 | Yes | No | Yes | No | First | Second | Third or more | ||
All ED visits N (millions) | 4,805 | 0,563 | 0,494 | 0,992 | 1,029 | 0,843 | 0,884 | 1,222 | 3,577 | 0,762 | 0,872 | 0,969 | 0,986 | 1,165 | 0,314 | 4,491 | 1,684 | 3,077 | 2,131 | 1,230 | 1,444 |
% row | 100.0 | 11.7 | 10.3 | 20.6 | 21.4 | 17.5 | 18.4 | 25.4 | 74.4 | 15.9 | 18.1 | 20.2 | 20.5 | 24.2 | 6.5 | 93.5 | 35.0 | 64.0 | 44.4 | 25.6 | 30.0 |
% | % | % | % | % | % | % | % | % | % | % | % | % | % | % | % | % | % | % | % | % | |
Same day (day 0) | 8.8 | 11.3 | 10.1 | 9.1 | 9.0 | 7.9 | 6.8 | 8.1 | 9.1 | 9.4 | 10.0 | 9.2 | 8.5 | 7.4 | 8.8 | 11.3 | 10.1 | 9.1 | 9.0 | 7.9 | 6.8 |
1 day before | 4.3 | 6.9 | 6.6 | 4.9 | 3.8 | 3.0 | 2.8 | 4.5 | 4.3 | 4.7 | 4.7 | 4.4 | 4.2 | 4.0 | 4.3 | 6.9 | 6.6 | 4.9 | 3.8 | 3.0 | 2.8 |
2–3 days | 5.5 | 10.3 | 8.7 | 6.3 | 4.3 | 3.4 | 3.4 | 5.7 | 5.5 | 5.8 | 5.8 | 5.5 | 5.3 | 5.4 | 5.5 | 10.3 | 8.7 | 6.3 | 4.3 | 3.4 | 3.4 |
ED followed by SSH N | 0,527 | 0,127 | 0,062 | 0,092 | 0,082 | 0,067 | 0,096 | 0,141 | 0,386 | 0,082 | 0,095 | 0,105 | 0,110 | 0,129 | 0,070 | 0,457 | 0,178 | 0,345 | 0,202 | 0,135 | 0,191 |
% row | 100.0 | 24 .1 | 11 .8 | 17 .5 | 15 .6 | 12 .7 | 18 .2 | 26 .8 | 73 .2 | 15 .6 | 18 .0 | 19 .9 | 20 .9 | 24 .5 | 13 .3 | 86 .7 | 33 .8 | 65 .5 | 38 .3 | 25 .6 | 36 .2 |
% | % | % | % | % | % | % | % | % | % | % | % | % | % | % | % | % | % | % | % | % | |
Same day (day 0) | 14.7 | 16.2 | 15.9 | 15.6 | 16.4 | 14.2 | 10.1 | 12.1 | 15.7 | 15.4 | 16.2 | 14.9 | 14.7 | 13.0 | 14.7 | 16.2 | 15.9 | 15.6 | 16.4 | 14.2 | 10.1 |
1 day before | 7.4 | 8.6 | 10.4 | 8.6 | 6.9 | 5.5 | 4.5 | 6.6 | 7.7 | 7.7 | 7.8 | 7.6 | 7.3 | 6.8 | 7.4 | 8.6 | 10.4 | 8.6 | 6.9 | 5.5 | 4.5 |
2–3 days | 8.0 | 11.6 | 11.1 | 8.8 | 6.2 | 4.8 | 4.6 | 7.4 | 8.3 | 8.0 | 8.3 | 8.2 | 7.8 | 8.0 | 8.0 | 11.6 | 11.1 | 8.8 | 6.2 | 4.8 | 4.6 |
ED without SSH N | 4,288 | 0,44 | 0,43 | 0,90 | 0,95 | 0,78 | 0,79 | 1,08 | 3,19 | 0,68 | 0,78 | 0,86 | 0,88 | 1,04 | 0,24 | 4,03 | 1,51 | 2,73 | 1,93 | 1,10 | 1,25 |
% row | 10,2 | 10,1 | 21,0 | 22,1 | 18,1 | 18,4 | 25,3 | 74,6 | 15,9 | 18,1 | 20,2 | 20,5 | 24,2 | 5,7 | 94,3 | 35,2 | 63,9 | 45,1 | 25,6 | 29,3 | 10,2 |
% | % | % | % | % | % | % | % | % | % | % | % | % | % | % | % | % | % | % | % | % | |
Same day (day 0) | 8,1 | 10,0 | 9,3 | 8,4 | 8,4 | 7,4 | 6,4 | 7,6 | 8,3 | 8,7 | 9,3 | 8,5 | 7,7 | 6,8 | 7,4 | 8,1 | 7,5 | 8,4 | 8,6 | 8,1 | 7,3 |
1 day before | 4,0 | 6,5 | 6,0 | 4,5 | 3,5 | 2,8 | 2,6 | 4,2 | 3,9 | 4,3 | 4,3 | 4,0 | 3,8 | 3,6 | 3,9 | 4,0 | 3,8 | 4,1 | 3,6 | 4,1 | 4,5 |
2–3 days | 5,2 | 10,0 | 8,3 | 6,1 | 4,1 | 3,2 | 3,3 | 5,5 | 5,2 | 5,5 | 5,5 | 5,2 | 5,0 | 5,1 | 5,1 | 5,2 | 5,1 | 5,3 | 4,4 | 5,4 | 6,5 |
Odds ratio (95% CI) | Odds ratio adjusted age and gender (95% CI) | Odds ratio adjusted Full model (95% CI) | |
---|---|---|---|
Age (Years) | |||
< 1 | 1 | 1 | |
1 | 1.41 [1.39–1.42] | 1.41 [1.40–1.42] | |
2–4 | 1.96 [1.94–1.97] | 1.96 [1.95–1.98] | |
5–9 | 2.65 [2.63–2.68] | 2.68 [2.65–2.70] | |
10–13 | 3.35 [3.31–3.38] | 3.40 [3.36–3.43] | |
14–17 | 3.40 [3.36–3.43] | 3.46 [3.43–3.50] | |
Gender | |||
Boys | 1 | 1 | |
Girls | 0.94 [0.93–0.94] | 0.91 [0.90–0.91] | |
CMUc vs no | 0.97 [0.96–0.98] | 1.0 [0.99–1.01] | 0.97 [0.97–0.98] |
FDep deprivation index (quintile) | |||
1 (less deprived) | 1 | 1 | |
2 | 1.00 [0.99–1.01] | 0.98 [0.97–0.99] | |
3 | 1.06 [1.05–1.07] | 1.04 [1.03–1.05] | |
4 | 1.11 [1.10–1.12] | 1.08 [1.07–1.09] | |
5 (most deprived) | 1.15 [1.13–1.16] | 1.13 [1.12–1.14] | |
Commune type | |||
Urban | 1 | 1 | 1 |
Rural | 1.04 [1.03–1.04] | 0.97 [0.96–0.98] | 1.01 [1.00–1.02] |
ED in the commune of residence vs no | 1.07 [1.06–1.08] | 1.11 [1.1–1.12] | 1.12 [1.11–1.13] |
At least one LTD vs no | 1.06 [1.05–1.07] | 0.89 [0.88–0.90] | |
Pervasive developmental disorders | 1.21 [1.16–1.26] | 0.91 [0.88–0.95] | 0.92 [0.88–0.95] |
Asthma | 0.79 [0.76–0.82] | 0.72 [0.69–0.74] | 0.73 [0.70–0.75] |
Specific developmental disorders of speech and language | 1.41 [1.31–1.51] | 1.04 [0.96–1.12] | 1.05 [0.98–1.14] |
Epilepsy | 1.25 [1.19–1.31] | 1.06 [1.01–1.12] | 1.09 [1.04–1.15] |
Unspecified mental retardation | 1.09 [1.02–1.16] | 0.84 [0.79–0.90] | 0.85 [0.80–0.91] |
Type 1 diabetes mellitus | 0.93 [0.89–0.98] | 0.67 [0.63–0.70] | 0.67 [0.64–0.71] |
Scoliosis | 1.23 [1.13–1.34] | 0.83 [0.76–0.90] | 0.84 [0.77–0.92] |
Specific developmental disorders of scholastic skills | 1.41 [1.29–1.55] | 0.97 [0.89–1.07] | 1.00 [0.91–1.09] |
Mixed disorders of conduct and emotions | 1.54 [1.41–1.68] | 1.03 [0.94–1.12] | 1.03 [0.94–1.12] |
Mixed specific developmental disorders | 1.20 [1.10–1.31] | 0.93 [0.85–1.02] | 0.93 [0.85–1.02] |
Congenital malformations of cardiac septa | 0.83 [0.77–0.89] | 0.89 [0.83–0.96] | 0.92 [0.86–0.99] |
At least one other LTD | 1.05 [1.03–1.06] | 0.92 [0.91–0.93] | 0.93 [0.92–0.94] |