Referral, admission, and discharge patterns in a pediatric emergency department in israel

Michal Rothschild, Shlomo Gilboa, Hana Sagi, Isaac Berger, Baruch Wolach

Research output: Contribution to journalArticlepeer-review


The pediatric emergency department (PED) is an important component of the medical services provided by a hospital. The purpose of the study was to describe the patterns of referrals, admissions, and discharges in a PED to determine to what extent the PED is used solely as an emergency unit, as opposed to being used as a part of a set of primary care facilities. Data were recorded from 1200 patient charts, out of 19,000 visits to a PED in Israel in 1988. Variables such as age, sex, ethnicity, and distance between residence and hospital were checked. About half of the patients arrived during the morning shift. There was an inverse relationship between the distance from the patient’s home to the hospital and the rate of visits to the PED. Fifty-eight percent of the total were self-referred; this rate increased to 84% during the night shift. Only one quarter of all children had additional laboratory or x-ray tests. Most of the diagnoses did not require emergency services. Eighty-one percent of the patients were discharged from the PED to their community physician. The rate of admissions was low (11 %). This study shows that a large part of the PED work is actually primary care. Some of the demographic, cultural, and ethnic reasons for these patterns are reviewed.

Original languageEnglish
Pages (from-to)72-76
Number of pages5
JournalPediatric Emergency Care
Issue number2
StatePublished - Apr 1993


  • Emergency department
  • Primary care
  • Referral visits


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