Emergency departments (EDs) see patients for nearly every kind of medical concern, prompting efforts to understand when and why people seek care. Total ED volume predictably varies by hour, day, and season, but such summaries can obscure how specific or co-occurring conditions drive demand. We analyzed 1.5 million pediatric ED and urgent care visits from 2010 to 2021 at a major children’s hospital in Ohio, a region with four distinct seasons.
Most chief complaints (CCs, 80%) showed clear seasonal rhythms, though peak timing varied widely by condition. Psychiatric emergencies, identified as a national crisis by the American Academy of Pediatrics, had some of the largest seasonal swings, peaking in spring and fall. ICD-10 profiles revealed subgroups within CCs that differed in seasonal timing, suggesting diverse underlying drivers.
Condition-specific weekly patterns also emerged, compounding seasonal effects and carrying implications for staffing and care. Psychiatric visits, for instance, were 70% higher in October than in June—but 220% higher on Mondays in October than on Saturdays in June, a pattern consistent over ten years. Parallel data from Brazil, with different environmental and social seasons, showed regional contrasts in ED use, including psychiatric cases.
Seasonal influences on pediatric emergency care are common, condition-specific, and regionally variable, underscoring the need to account for them in health system planning and etiologic research. Anonymized data and code for reproducing the analyses in this study are available at https://zenodo.org/records/14502802 This work is supported by Cincinnati Children’s Hospital Medical Center (D.F.S., J.B.H., and M.D.R) (National Institute of Allergy and Infectious Diseases of the National Institutes of Health, K23AI175525). Division of Biomedical Informatics, Cincinnati Children’s Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229-3026, USA Patricia Tachinardi, Eneida A.
Ruben Division of Neurology, Cincinnati Children’s Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229-3026, USA Division of Pulmonary Medicine, Cincinnati Children’s Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229-3026, USA Rochelle M. Ruben Division of Human Genetics, Cincinnati Children’s Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229-3026, USA Gang Wu, Jiffin K. Hogenesch Division of Emergency Medicine, Cincinnati Children’s Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229-3026, USA Division of Critical Care Medicine, Cincinnati Children’s Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229-3026, USA Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, 3333 Burnet Avenue, Cincinnati, OH, 45229-3026, USA Department of Pediatrics, University of Cincinnati College of Medicine, 3333 Burnet Avenue, Cincinnati, OH, 45229-3026, USA Rochelle M.
Witt, Gang Wu, Timothy E. Ruben The authors declare no competing interests. This study was conducted in accordance with the principles of the Declaration of Helsinki.
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