Self-referrals to the A&E department during out-of-hours: Patients' motives and characteristics
Self-referrals to the A&E department during out-of-hours: Patients' motives and characteristics
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DOI：
10.1016/j.pec.2007.10.012
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发表时间：
2008-02-01
影响因子：
3.5
通讯作者：
Bindels, Patrick
中科院分区：
文献类型：
--
作者：
van Charante, Eric Peter Moll;ter Riet, Gerben;Bindels, Patrick
目的：目的：了解急诊科患者就诊的动机，并与普通科门诊患者进行比较。方法：对急诊科患者进行邮寄问卷调查，采用Logistic回归分析比较急诊科患者与普通科门诊患者的就诊动机。对于62，000名研究人群，在4个月内，在GP合作社登记了5547名联系人，沿着有808名AED联系人，其中344人（43%）为自我转诊。访问AED的主要原因是认为需要诊断设施，并相信医院专家最有资格处理这个问题。受访者对全科医生合作社的不满程度很高。自我转诊到AED是正相关的伤害，年龄在15和64之间，肌肉骨骼，心血管和呼吸系统的问题，距离GP centre.Conclusion：自我转诊出现的病人有强烈的偏好AED，主要是基于对护理质量和必要设施的假设。虽然自我转诊可能会在一定程度上做出积极和适当的选择去看AED，但应研究新的综合护理模式，以充分转移那些有资格接受全科医生护理的人。(C)2007爱思唯尔爱尔兰有限公司保留所有权利。
Objective: To determine self-referrals' motives to visit the accident & emergency departments (AED) and to compare their characteristics to patients contacting the GP cooperative.Methods: Postal questionnaires were send to AED self-referrals and logistic regression analysis was used to contrast self-referrals to patients contacting the GP cooperative.Results: For a study population of 62,000, during 4 months, 5547 contacts were registered with the GP cooperative, along with 808 AED contacts, 344 of whom (43%) were self-referrals. Main reasons to visit the AED were the perceived need for diagnostic facilities and the conviction that the hospital specialist was best qualified to handle the problem. Dissatisfaction with the GP cooperative among respondents was high. Self-referral to the AED was positively associated with injury, age between 15 and 64, musculoskeletal, cardiovascular and respiratory problems, and distance to the GP centre.Conclusion: Self-referrals emerge as patients with a strong preference for the AED, mainly based on assumptions on quality of care and necessary facilities.Practice implications: While self-referrals may, in part, make motivated and appropriate choices to visit the AED, new integrated care models should be studied that can adequately deflect those who are eligible for GP care. (C) 2007 Elsevier Ireland Ltd. All rights reserved.