ORIGINAL RESEARCH: EMPIRICAL RESEARCH –
QUANTITATIVE
Deprivation and its impact on non-urgent Paediatric Emergency
Department use: are Nurse Practitioners the answer?
Yvonne Karen Parry, Shahid Ullah, Jeremy Raftos & Eileen Willis
Accepted for publication 10 August 2015
Correspondence to Y.K. Parry:
e-mail: yvonne.parry@flinders.edu.au
Yvonne Karen Parry MHSM PhD RN
Senior Lecturer
School of Nursing & Midwifery, Faculty of
Medicine, Nursing and Health Sciences,
School of Nursing & Midwifery, Flinders
University, Adelaide, South Australia,
Australia
Shahid Ullah PhD
Senior Lecturer in Biostatistics
Flinders Centre for Epidemiology and
Biostatistics, Faculty of Health Sciences,
Flinders University, Adelaide, South
Australia, Australia
Jeremy Raftos MBBS FRACP
Director of Paediatric Emergency Medicine
Emergency Department, Women’s and
Children’s Hospital, North Adelaide, South
Australia, Australia
Eileen Willis BEd MEd PhD
Professor
School of Health Science, Faculty of
Medicine, Nursing and Health Sciences,
Flinders University, Adelaide, South
Australia, Australia
PARRY Y.K., ULLAH S., RAFTOS J. & WILLIS E. (2015) Deprivation and its
impact on non-urgent Paediatric Emergency Department use: are Nurse Practi-
tioners the answer? Journal of Advanced Nursing 00(0), 000–000. doi:
10.1111/jan.12810
Abstract
Aims. This article reports on the quantitative findings from a large mixed method
study that determined the extent to which the provision of alternatives to an
Emergency Department and Index of Relative Social Disadvantage score
influenced non-urgent paediatric Emergency Department use.
Background. In Australia, there is an increasing use of Emergency Departments for
the provision of non-urgent care that may be better serviced in the community.
Further, despite the plethora of literature describing the characteristics of non-urgent
users of Emergency Departments the link to social and community characteristics
remains under explored.
Design. This 2010 retrospective analysis of the Hospital Admission Status data
from the paediatric Emergency Department provided the information on
attendance types and numbers along with postcode details. The postcodes in
conjunction with Australia Bureau of Statistics data provided the levels of
deprivation from the Index of Relative Social Deprivation scores.
Method. A logistic regression analysis determined the levels of influence of
deprivation and General Practitioner or Nurse Practitioner provision on the use of
Emergency Departments for non-urgent care.
Findings. Rates of use for non-urgent care is higher for populations who come
from areas of deprivation and have limited primary care services, such as low
levels of General Practitioners. Children from areas of high deprivation and
limited access to primary care were up to six times more likely to use Emergency
Department for non-urgent care.
Conclusions. Deprivation impacts on the use of paediatric Emergency
Departments for non-urgent care even in countries like Australia where there is
government subsidized health care.
© 2015 John Wiley & Sons Ltd 1