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Work-Family Crunch: Parents Resort To ER To Get Kids Back Into Daycare

(Bob Reck via Compfight)

(Bob Reck via Compfight)

Some of the tension between work and family is inevitable. If your child comes down with the flu on the very day you’re supposed to give a major presentation, there’s just no way you can be everywhere you’re needed at the same time.

But a study just out in the journal Pediatrics shows that the discrepancy between the sick-child policies at many daycare centers and accepted medical wisdom could often make the work-family crunch harder than it has to be. (Meanwhile, a day-long White House “summit” today is looking at ways to ease that crunch for American parents, from promoting more flexible work schedules to paid maternity leaves.)

From the study’s press release:

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, to be published June 23 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. This is the first national study to examine the impact of illness for children in child care on parents’ need for urgent medical evaluations, says Hashikawa.

In the study, 80 percent of parents took their children to a primary care provider when their sick children were unable to attend child care. Twenty-six percent of parents also said they had used urgent care and 25 percent had taken their children to an emergency room.

“These parents may view the situation as a socioeconomic emergency,” Dr. Hashikawa says.

He got interested in this topic, he told me, when he was a med student working in an ER, and one night, a family brought in children who looked fine, they just had a little bit of red in their eyes. “And it was midnight, and I asked them, ‘Why are you here?’ I was just so curious. And they said ‘Well, I’ve got to work, I’m not going to get paid, and I really need a doctor’s note for both my work and for my daycare so I can send them back.'”

A bit more of our conversation, lightly edited:

How much does daycare keep kids out unnecessarily?

There are different ways to look at it…A Maryland study showed that for every one appropriate exclusion (from daycare) approximately five or six were inappropriate exclusions. I did a study from a daycare provider standpoint: If we gave you a hypothetical scenario, how many of these kids would you send home that probably didn’t need to be excluded? It seemed that 57% of kids would be unnecessarily excluded at that point.

The American Academy of Pediatrics has guidelines on when children should actually be kept home, right? Continue reading