Overestimation of health urgency as a cause for emergency services inappropriate use: Insights from an exploratory economics experiment in Portugal
Overestimation of health urgency as a cause for emergency services inappropriate use: Insights from an exploratory economics experiment in Portugal
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DOI：
10.1111/hsc.12720
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发表时间：
2019-07-01
影响因子：
2.4
通讯作者：
Veiga, Paula
中科院分区：
文献类型：
--
作者：
Botelho, Anabela;Dias, Isabel Correia;Veiga, Paula
越来越多的人去急诊室就诊，给公共医疗系统增加了压力。对症状严重性的误解可以部分解释非紧急患者不适当地使用医院急诊室。本文着重于症状的严重性的误解，作为一个原因，不适当地使用急诊科。它探讨了告知潜在患者正确的严重程度可以在纠正这种低效率方面发挥的作用。我们以激励的方式实施了一项探索性的经济实验，以得出五组症状的严重程度，对应于急诊室就诊的频繁原因。该研究在葡萄牙北方的布拉加进行，通过当地民间组织招募志愿参与者。我们要求参与者在揭示真实严重程度之前和之后指出更合适的卫生服务。结果表明，有一个高估的严重程度的一些临床概况，当面对真实的严重性，在只有一半的情况下，选择改变到其他卫生服务。虽然是探索性的，这项研究提供了有关症状严重程度的健康教育政策的潜在作用的见解，但它也强调了这些政策的局限性。此外，经济实验的使用可以为解决需求侧医疗保健效率低下的政策设计提供有意义的见解。
Increasing visits to emergency departments add strain to public healthcare systems. The misperception of symptoms' severity can partly explain inappropriate use of hospitals' emergency departments by non-urgent patients. This paper focuses on the misperception of symptoms' severity as a cause for the inappropriate use of emergency departments. It explores the role that informing potential patients of the correct severity level can play in correcting this inefficiency. We implement in an incentivised manner an exploratory economic experiment to elicit the degree of severity of five sets of symptoms, corresponding to frequent causes of emergency department visits. The study was setup in Braga, Northern Portugal, recruiting voluntary participants through civic local organisations. We ask participants to indicate the more suitable health service, before and after revealing the true degree of severity. Results show that there is an overestimation of the degree of severity of some clinical profiles, and when confronted with the real severity, in only half of the cases are choices changed to other health services. Although exploratory, this study provides insights into the potential role of health education policies concerning symptoms' severity but it also highlights the limits of such policies. Furthermore, the use of economic experiments can provide meaningful insights for the design of policies addressing demand-side healthcare inefficiencies.