Emergency department crowding: why do patients walk-in?
Emergency department crowding: why do patients walk-in?
复制标题
DOI：
10.1080/17843286.2019.1710040
复制
发表时间：
2020-01-01
影响因子：
1.6
通讯作者：
Ghuysen, Alexandre
中科院分区：
文献类型：
--
作者：
Brasseur, Edmond;Gilbert, Allison;Ghuysen, Alexandre
目的：多年来，全科医生（GP）短缺和患者对急诊护理需求的增加与急诊科（艾德）拥挤有关。事实上，急诊科非急诊护理的入院人数似乎在不断增加。令人惊讶的是，病人自己决定直接接触急诊室的基本原理到目前为止还没有得到很好的研究。方法：我们进行了一项研究，在两个大学急诊科连续九天收治的患者。患者被要求回答一项关于他们来的框架的调查，以及他们是否是自我推荐的，由全科医生，专家或拨打紧急电话后推荐的。结果如下：在研究期间，68.0%的患者是自我转诊，17.0%是由他们的GP转诊，8.5%是由专家转诊，7%是在紧急呼叫后转诊。51.0%的自我转诊者认为急诊室是处理自己健康问题的合适场所，24.0%的自我转诊者认为急诊室的便利性更好。我们注意到，15.0%的住院患者寻求专业护理，4.22%的患者报告说压力促使他们这样做。值得注意的是，4.6%的患者被医院的声誉所吸引。财务问题占不到1.0%的动机援引。结论：本研究发现病患自感病情严重度是各艾德面对急症照护需求时的主导架构。与其他设施相比，急诊室的可达性似乎也鼓励病人来急诊室。其他因素，如医院声誉或病人的压力往往会影响艾德的出勤率，但程度要小得多。
Objectives: For years, general practitioners (GP) shortage and patients' increasing demand for acute care have been associated with Emergency Department (ED) crowding. Indeed, EDs admissions for non-emergency care seem to constantly increase. Surprisingly, the rationale for patients own decision to directly reach EDs over primary care have been poorly investigated to date. Methods: We conducted a study on patients admitted in two University EDs during nine consecutive days. Patients were asked to answer a survey about their frames for coming and if they were self-referred, referred by a GP, a specialist or after calling the Emergency Number. Results: During the study period, 68.0% of patients were self-referred, 17.0% referred by their GP, 8.5% by a specialist and 7% after an emergency call. 51.0% of the self-referrals thought EDs were the appropriate location to deal with their health problem and 24.0% because of a better accessibility. We noticed that 15.0% of the incomings looked for specialized care and 4.22% reported that the stress had motivated them. Of note, 4.6% of the patients were attracted by the hospital reputation. Financial concerns represented less than 1.0% of the motives invocated. Conclusion: We found that patients' self-perceived severity of illness is the predominant frame to each the ED when they face needs for acute care. EDs' accessibility as compared with other facilities also seems to encourage patients to come to the ED. Other factors such as the hospital reputation or patients' stress tend to influence ED attendance but to a much lesser extent.