Tertiary pediatric emergency department admission rates fall as waiting times increase

Objectives: To examine whether children in the same triage category presenting to a tertiary paediatric emergency department are more likely to be admitted to hospital if their wait is longer. Methods: Retrospectively during a 7-year period, we determined the admission rate of children with lower acuity triage scores and compared 3 groups; those seen in their recommended triage time (group A), those seen under twice their recommended time (group B), and those seen in over twice their recommended time (group C). Results: Patients in groups B and C were less likely to be admitted for both triage categories 3 and 4 compared with group A (P < 0.005 for all admission rate comparisons). This held true in individual diagnostic groups. Conclusions: Predictably, but reassuringly, those patients waiting longer than the recommended category time are no more likely to get admitted and do not represent a grossly different subset of patients in terms of age and diagnosis. Further work is needed to identify, at the point of triage, the characteristics of children who are unlikely to deteriorate during their wait.