(HealthDay News) — Eight percent of children account for nearly one-quarter of emergency department visits and 31% of costs, according to a study published online September 15 in Pediatrics.

Mark I. Neuman, MD, MPH, from Boston Children’s Hospital, and colleagues conducted a retrospective study involving 1,896,547 0–18-year-olds with 3,263,330 visits to 37 emergency departments in 2011. They compared the characteristics and emergency department health services of children based on the frequency of emergency department visits.

The researchers found that 8% of children with ≥4 emergency department visits accounted for 24% of all visits and 31% ($1.4 billion) of all costs. With increasing visit frequency, there was an increase in the percentage of infants and a decrease in the percent of children with chronic conditions. A higher percentage of visits without medication administration (aside from acetaminophen or ibuprofen), testing, or hospital admission was seen in children with ≥4 emergency department visits vs. children with one visit (35.4 vs. 29.0%; P<0.001). This type of visit was most common among children with ≥4 emergency department visits who were aged <1 year (odds ratio [OR], 3.8) and who were without a chronic condition (OR, 3.1).

“With a disproportionate share of pediatric emergency department cost and utilization, frequent utilizers, especially infants without a chronic condition, are the least likely to need medications, testing, and hospital admission,” the authors write.

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