Investigation of Patients Refusing Treatment in the Pediatric Emergency Service During the COVID-19 Pandemic

• DOI: 10.4274/tp.2022.58966
• Publication Date: 2022-09-30T07:51:11Z
• Authors: Nihal Cankır; Feyza Hüsrevoğlu ...; Yasemin Akın
• Keywords: 03 medical and health sciences; pediatric patients; 0302 clinical medicine; Emergency department; COVID-19; refusal of treatment; Pediatrics; RJ1-570

Objective: Emergency departments are becoming increasingly crowded. Analyzing patients who refuse treatment in the emergency department is crucial to improve the quality of care and reduce overcrowding. This study determined why some parents who presented to the pediatric emergency department during the coronavirus disease-2019 (COVID-19) pandemic refused treatment for their children. Materials and Methods: The study was conducted at the Kartal Dr. Lütfi Kırdar City Hospital, Pediatric Emergency Clinic. Patients who presented to the pediatric emergency department between November 1, 2021 and December 31, 2021 and whose parents refused treatment were analyzed retrospectively via telephone interviews. Demographic characteristics, diagnosis, and reasons for refusal to treatment were analyzed. Results: Over the 2-month period, parents of 154 (0.3%) of 51.111 patients who presented to the pediatric emergency department refused treatment. Parents refused treatment for the following reasons: 68 (44%) parents refused treatment because the patient felt well, 36 (23%) wanted to continue treatment at home, and 18 (11%) wanted to avoid hospitalization. Of the patients who refused treatment, 16 (10%) returned to the pediatric emergency department within 72 h with the same symptoms, and 5 of them were hospitalized. Conclusion: The COVID-19 pandemic has increased patients’ refusal to treatment because of the fear of infection. The inappropriate use of emergency services, which leaves physicians with insufficient time to explain medical examinations and treatments to the family members of patients in a clear and understandable language, as well as the patients’ right to re-present to hospitals after refusing treatment, are the main reasons. Actions should be taken to improve working conditions, increase satisfaction of healthcare professionals, raise awareness among patients and their family members and reduce overcrowding at emergency departments. These actions can prevent treatment refusal, even during the COVID-19 pandemic.