Community-Acquired Pneumonia in Young Children: Variables Associated With Emergency Department Attendance and Hospitalization

Aim: This study was aimed at identifying variables associated with attending pediatric emergency departments (PEDs) and hospitalization of young children with community-acquired pneumonia (CAP). Methods: A population-based case-control study, which included all children aged 1–6 years diagnosed with CAP from three major districts of a health maintenance organization during 2014–2020. Children born preterm, or with chronic lung diseases or immunodeficiency, were excluded. The cohort was divided into three groups: children diagnosed and treated by the community pediatrician, those who attended PEDs, and those hospitalized. Results: The cohort comprised 59,662 children with CAP, of whom 3685 (6.2%) attended PEDs and 2026 (3.4%) were hospitalized. Of the children treated in the PED, 33% were hospitalized versus 1.4% of those diagnosed in the community. Using multivariable analyses, members of a minority sector, low or middle socioeconomic status, elevated white blood cell count, and high C-reactive protein levels were independently and significantly associated with PED attendance and hospitalization. Conclusion: Community pediatricians should integrate the identified variables associated with attending PEDs and hospitalization to optimize management of children with CAP, given the potential for complications and mortality. The recognized 6.2% PED attendance and 3.4% hospitalization, with the identified related associations, have implications for pediatric healthcare planning.