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

Mark I. Neuman, M.D., M.P.H., from Boston Children's Hospital, and colleagues conducted a involving 1,896,547 0- to 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 percent of children with four or more emergency department visits accounted for 24 percent of all visits and 31 percent ($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 . A higher percentage of visits without medication administration (aside from acetaminophen or ibuprofen), testing, or hospital admission was seen in children with four or more emergency department visits versus children with one visit (35.4 versus 29.0 percent; P < 0.001). This type of visit was most common among with four or more 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 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.