Evaluation of Demographic and Clinical Characteristics of Pediatric Emergency Department Visits in Southeastern Turkey, 2023

Abstract

Background: Emergency department (ED) overcrowding remains a significant challenge in many healthcare systems, including Türkiye. Pediatric emergency services in particular face high visit volumes, often driven by non-urgent complaints. Understanding the patterns and characteristics of these visits is crucial to optimize healthcare delivery and reduce unnecessary ED utilization. Objectives: This study aimed to evaluate the demographic and clinical characteristics of pediatric emergency department visits over a one-year period in southeastern Turkey. The goal was to identify common complaints, peak visit times, and seasonal trends to inform public health strategies and reduce inappropriate ED use. Methods: A retrospective cross-sectional study was conducted using routinely collected administrative data from pediatric ED visits to the Batman İluh State Hospital pediatric emergency department between January 1 and December 31, 2023. All visits by patients < 18 years of age were included; no sampling was performed. Demographic variables (age, sex), temporal variables (hour, day, month/season of visit), clinical variables (chief complaints, ICD-based diagnoses), and disposition outcomes (discharge, ward admission, intensive care unit [ICU] admission, referral, death) were analyzed descriptively. For selected key proportions, 95% confidence intervals (CIs) were calculated using binomial methods. Results: A total of 192,661 pediatric emergency visits were recorded during the study period; 52.0% of visits were by boys and 48.0% by girls. The highest number of pediatric ED visits occurred during winter (29.19%; 95% CI 29.0 - 29.4), followed by spring (25.22%), autumn (24.77%), and summer (20.82%); most visits took place between 16:00 and 00:00 (64.25%). Upper respiratory tract infection (URTI) was the most frequent diagnosis, accounting for 64.1% (n = 123,491; 95% CI = 63.9 - 64.3) of all visits, followed by acute gastroenteritis (15.06%). Only a small proportion of visits resulted in hospital admission (0.94%; 95% CI = 0.90 - 0.98), ICU admission (0.11%; 95% CI = 0.10 - 0.13), or referral to a tertiary center (0.09%; 95% CI = 0.08 - 0.10); four deaths occurred in the ED (n = 4; 0.002% of visits). Conclusions: A substantial proportion of pediatric emergency visits in this high-volume center appears to be potentially avoidable and is dominated by non-urgent infectious conditions. These findings highlight the need for targeted interventions—such as parent education, after-hours pediatric care alternatives, and strengthened primary health care services—to reduce unnecessary ED utilization, guide staffing strategies, and improve resource allocation in similar settings.