Working parents resort to emergency or urgent care visits to get kids back into child care

http://www.eurekalert.org/pub_releases/2014-06/uomh-wpr062314.php

23-Jun-2014
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Contact: Mary Masson
mfmasson@umich.edu
734-764-2220
University of Michigan Health System
Working parents resort to emergency or urgent care visits to get kids back into child care

Child care rules about illness create socioeconomic emergency for many working parents, especially African Americans, single/divorced parents

Ann Arbor, Mich. — Substantial proportions of parents chose urgent care or emergency department visits when their sick children were excluded from attending child care, according to a new study by University of Michigan researchers.

The study, published today in Pediatrics, also found that use of the emergency department or urgent care was significantly higher among parents who are single or divorced, African American, have job concerns or needed a doctor's note for the child to return.

Previous studies have shown children in child care are frequently ill with mild illness and are unnecessarily excluded from child care at high rates, says Andrew N. Hashikawa, M.D., M.S., an emergency physician at C.S. Mott Children's Hospital.

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"These parents may view the situation as a socioeconomic emergency, and therefore choose urgent or emergency room care over the inability to return to work," says Hashikawa. "Parents without sick leave benefits face a considerable problem when they risk loss of wages or loss of a job to stay home with a child excluded from child care."

That's why policies that exclude children unnecessarily have a big impact for families and employers, says Matthew Davis, M.D., M.A.P.P., director of the C.S. Mott Children's Hospital National Poll on Children's Health. The poll's survey was used in this study.

Many child care settings require a health care visit or doctor's note before a child may return, which is in direct conflict with the national child care recommendations of the American Academy of Pediatrics, says Hashikawa.

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Previous research has shown that more than half of the 25 million pediatric visits to the emergency department each year are for non-urgent conditions. Using emergency rooms for non-urgent care leads to increased cost, prolonged wait times and patient dissatisfaction.

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"Caring for kids who are sick can be a challenge for child care providers. Many have high-turnover of staff, poor pay, and lack of available health-related training. Some parents may also believe that any sick children should be excluded from child care, even though guidelines are clear that exclusions for mild illness are not necessary," says Davis, who is also professor of pediatrics, internal medicine, public policy, and health policy and management at the University of Michigan.

Hashikawa recommends widespread sharing of the national American Academy of Pediatrics guidelines at the state and national level and training child care professionals regarding appropriate illness exclusions. He says that may reduce the unnecessary exclusion of children from child care, thereby reducing unnecessary visits to emergency department and/or urgent care centers and possibly decreasing parental work absenteeism.