Dear Editors,

With great interest, and together with medical students from the University of Azuay, we conducted the research study titled “Demand for Pediatric Emergency Care in a General Hospital in Ecuador”. In this work, we analyze the demand in pediatric emergency services in our country. The findings, which reveal a high proportion of non-urgent visits, highlight a reality shared by many health systems in the region and around the world: the need to optimize emergency care in order to ensure more efficient use of resources and improve the quality of services.

Analyzing the reasons for emergency care in pediatric patients is a fundamental exercise. It is not merely a sta­tistical figure; rather, it is a diagnostic tool that allows us to understand the true needs of the pediatric population requiring emergency attention. Knowing that all centers report respiratory, gastrointestinal, and trauma-related conditions as the main reasons for consultation^(1,2) en­ables the design of more effective public health strategies focused on prevention and education.

The study showed that almost half of the visits were non-urgent, reflecting a gap in trust and access to primary care. Parents’ perception of severity—often influenced by limited health education—overloads emergency services with cases that could be resolved at the primary care level⁽³⁾. This inappropriate use not only delays care for truly severe cases but also diverts valuable resources from other critical areas.

Various studies report similar findings, prompting re­flection on the actions that should be taken. First, strength­ening the primary care network is essential so that it becomes the first point of contact and the main reference for families. This requires improving infrastructure, increas­ing specialized staff, and developing educational cam­paigns that inform parents about when and where to seek medical care. Second, the importance of implementing efficient triage systems is evident, as they allow for prop­er patient classification and ensure that the most severe cases receive the priority they deserve⁽⁴⁾. An interesting finding was that peaks in care at the beginning of the week and the seasonality of certain diseases (such as respiratory infections) provide a solid basis for better hospital staffing and resource planning.

In conclusion, the results of our study, together with those reported in the international literature, represent a cornerstone for healthcare management. By understanding the reasons behind each consultation, we can move from reactive care to a proactive and preventive model. These results are a call to action for all stakeholders in the health system to work together and ensure that every child re­ceives the right care, in the right place, and at the right time.

References 

1. Téllez MC, Madrigal MAP. Most frequent reasons for consultation in the pediatric emergency department of the Río Hortega University Hospital of Valladolid. 2022;19(119):13.
2. Muñoz García JL, Fandiño Orgeira JM, Díaz Peromingo JA. Demand for pediatric emergency care in a regional hospital. Aten Primaria. 2008;40(6):297–301.
3. Pérez RP, Archidona CM, Martín DH, Verrier EC, Aguado IC. Frequent users in Pediatric Emergency Departments: is it all the parents' fault? Rev Pediatr Aten Primaria. 2017;19:137–45.
4. Landaluce AF. Diagnostic and therapeutic protocols in Pediatric Emergency Care: Pediatric emergency triage. 4th ed. Spain: Spanish Society of Pediatric Emergency Care (SEUP); 2024.