Do children with ADHD use the Emergency Department more often? — retrospective cohort study
DOI:
https://doi.org/10.25753/BirthGrowthMJ.v34.i4.42580Keywords:
ADHD, disease, emergency departmentAbstract
Introduction: Attention-deficit/hyperactivity disorder (ADHD) has been associated with increased use of emergency department (ED) services. This study aims to compare ED visits due to illness between children with and without ADHD at a level I hospital in Portugal.
Methods: A retrospective cohort study was conducted including a sample of children diagnosed with ADHD and a control group of children without neurodevelopmental disorders.
Data were collected on the number of illness-related ED visits from the age of six years onwards, as well as severity of the episode (i.e., triage category, need for additional exams, and hospitalisation).
Results: The sample included 316 cases and 316 controls, with a mean age of 11.9 ± 2.4 years in both groups. Children with ADHD had a higher rate of illness-related ED visits compared to the control group, with an incidence rate ratio (IRR) of 1.67 (p<0.001). Even after excluding children with other underlying conditions such as asthma, the ADHD group continued to show higher ED utilization (IRR 1.45; p<0.001).
The ADHD patients also had more ED visits related to anxiety (p=0.022) and were triaged as ‘more urgent’ more often (p<0.001), although no difference was found regarding hospitalization rates (p=0.206).
Conclusion: This study demonstrates an association between ADHD and increased utilization of the ED for illness-related reasons. Despite being categorized as higher urgency cases upon triage, patients with ADHD did not show a greater need for hospitalization.
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