Comparing care at walk-in centres and at accident and emergency departments: an exploration of patient choice, preference and satisfaction
Comparing care at walk-in centres and at accident and emergency departments: an exploration of patient choice, preference and satisfaction
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DOI：
10.1136/emj.2006.042499
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发表时间：
2007-04-01
影响因子：
3.1
通讯作者：
Salisbury, Chris
中科院分区：
文献类型：
--
作者：
Chalder, Melanie;Montgomery, Alan;Salisbury, Chris
目的：探讨与急诊科同时设立无预约中心对患者选择、偏好和满意度的影响。方法：采用对照、混合方法对8个急诊科与同一数量的“传统”急诊科的无预约中心进行比较。结果：调查数据显示，患者经常无法区分是在无预约中心还是在急诊室接受治疗，即使是在这种情况下，对他们首选的护理提供者进行选择的机会也往往有限。很少有人主动选择参加同一地点的无预约中心。无预约中心的患者与在同一地点的急症室接受治疗的患者相比，对他们所得到的护理总体满意度是一样的，尽管无预约中心的使用者报告对他们的护理和咨询的某些特定方面的满意度更高。结论：尽管支持将无预约中心设在急症室旁边的关键政策目标之一是为患者提供更多的医疗保健选择和更多的选择，进而导致更高的满意度，但这项评估未能提供多少证据来支持这一点。与新的无预约中心设施相比，患者表示倾向于在现有急诊科接受治疗的比例较高，这对未来的政策制定提出了问题。因此，在病人选择方面，我们应进一步考虑急症室中心在卫生署现行政策纲领中所扮演的角色。
Objectives: To explore the impact of establishing walk-in centres alongside emergency departments on patient choice, preference and satisfaction.Methods: A controlled, mixed-method study comparing 8 emergency departments with co-located walk-in centres with the same number of "traditional'' emergency departments. This paper focuses on the results of a cross-sectional questionnaire survey of users.Results: Survey data demonstrated that patients were frequently unable to distinguish between being treated at a walk-in centre or at an accident and emergency (A&E) department and, even where this was the case, opportunities to exercise choice about their preferred care provider were often limited. Few made an active choice to attend a co-located walk-in centre. Patients attending walk-in centres were just as likely to be satisfied overall with the care they received as their counterparts who were treated in the co-located A&E facility, although walk-in centre users reported greater satisfaction with some specific aspects of their care and consultation.Conclusions: Whereas one of the key policy goals underpinning the co-location of walk-in centres next to an A&E department was to provide patients with more options for accessing healthcare and greater choice, leading in turn to increased satisfaction, this evaluation was able to provide little evidence to support this. The high percentage of patients expressing a preference for care in an established emergency department compared with that in a new walk-in centre facility raises questions for future policy development. Further consideration should therefore be given to the role that A&E- focused walk-in centres play in the Department of Health's current policy agenda, as far as patient choice is concerned.