Barriers to Primary Care: Perceptions of Older Adults Utilizing the ED for Nonurgent Visits
Barriers to Primary Care: Perceptions of Older Adults Utilizing the ED for Nonurgent Visits
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DOI：
10.1177/1054773813485597
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发表时间：
2013-11-01
影响因子：
1.7
通讯作者：
Rebholz, Casey M.
中科院分区：
文献类型：
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作者：
D'Avolio, Deborah A.;Strumpf, Neville E.;Rebholz, Casey M.
这项混合方法研究的目的是了解向市中心急诊科(ED)寻求非紧急护理的老年人获得初级保健的情况。调查问卷(N=62)包括人口统计、疾病特征和卫生保健利用情况。定性访谈(N=20)进行。使用描述性统计和定性方法对数据进行分析。超过一半的参与者是女性(60%)，非裔美国人(57%)，48%的参与者以疼痛为主要症状。几乎所有参与者都报告了初级保健方面的障碍；电话系统和工作人员方面的困难，以及缺乏可用预约导致急诊室就诊。老年人在获得初级保健方面面临障碍，因此可以向教育署寻求初级保健需求。改善弱势老年人机会的干预措施可能不仅对患者结果有好处，而且对与成本效益高的护理和过度拥挤的急诊室有关的卫生政策问题也有好处。
This purpose of this mixed methods study was to understand access to primary care among older adults who present to an inner city emergency department (ED) for nonurgent care. Questionnaires (N = 62) included demographic, illness characteristics, and health care utilization. Qualitative interviews (N = 20) were conducted. Data was analyzed using descriptive statistics, and qualitative methodology. More than half of the participants were female (60%), African American (57%) and pain was the presenting symptoms among 48% of the participants. Nearly all participants reported barriers to primary care; difficulty with phone systems and staff, and lack of available appointments resulting in an ED visit. Older adults face barriers accessing primary care and as a result, can turn to the ED for their primary care needs. Interventions to improve access for vulnerable older adults might have benefits not only for patient outcomes but also for health policy issues related to cost effective care and overcrowded EDs.