Effect of Childhood Disease on Hospital Presentation: A Survey of Pediatricians.

Background: Determining when caregivers should take their children to a hospital is crucial in ensuring the health and safety of children. Because children cannot make these decisions on their own, caregivers bear the core responsibility for the wellness of their children. The aim of this study was to determine how disease, disability, and child behavior affect when and how often caregivers take their children to a hospital.

Methods: A structured anonymous online survey was circulated to pediatricians in Japan. Pediatricians were queried about the characteristics of their patients, including reactivity to pain, expression of pain, behavior at the hospital, and the timing of presentation. Patients were school-aged children and included those with autism spectrum disorder, attention-deficit hyperactivity disorder, Down syndrome, mental retardation, epilepsy, premature birth, and allergies.

Results: Sixty-eight of 80 pediatricians responded to the survey (85% response rate). The results indicated that caregivers of children with autism spectrum disorder, attention-deficit hyperactivity disorder, and mental retardation took them to the hospital later than was optimal. Conversely, children born prematurely and those with allergies were taken to hospitals even when symptoms were mild.

Conclusions: Caregivers make decisions on when to present to hospital on the basis of their child's expression of pain and behavior. Guidelines should be developed to assist caregivers in determining when to present for treatment at a hospital.