Appropriateness of Emergency Department Use in Pediatric Inflammatory Bowel Disease: A Quality Improvement Opportunity

Objectives: We sought to characterize emergency department (ED) encounters for pediatric inflammatory bowel disease (IBD) to identify areas for prevention. Methods: Retrospective chart review of 5 consecutive ED encounters at 7 centers was performed. Results: Of 35 unique encounters by 32 patients, 3 main factors contributed to ED utilization: disease severity or course, day or time of care, and physician instruction. Of the ED encounters, approximately one-fifth were judged medically unnecessary, and one-half avoidable in a more optimal health care system. Conclusions: ED visits by pediatric patients with IBD may be reduced in a more optimal health care system.