Pre- and post-home visit behaviors after using after-hours house call (AHHC) medical services: a questionnaire-based survey in Tokyo, Japan.
Pre- and post-home visit behaviors after using after-hours house call (AHHC) medical services: a questionnaire-based survey in Tokyo, Japan.
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使用下班后上门服务（AHHC）后的家访行为：一项基于日本东京的问卷调查。
DOI：
10.1186/s12873-021-00545-w
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发表时间：
2021-12-15
影响因子：
2.5
通讯作者：
Tamiya N
中科院分区：
文献类型：
--
作者：
Inokuchi R;Morita K;Jin X;Ishikawa M;Tamiya N
日本已实施下班后出诊医疗服务，以减少救护车的使用以及急诊室（艾德）的过度拥挤。检查那些使用AHHC医疗服务的家庭访问前和访问后的行为将提供这些服务的有用性的见解，并帮助制定战略，以减少艾德访问和救护车的使用进一步。这项研究使用了2019年1月1日至12月31日期间在日本东京使用AHHC医疗服务的患者完成的匿名医疗记录和基于互联网的问卷调查数据。问卷包括两个问题：（1）在没有AHHC服务的情况下，患者会采取什么行动;（2）在使用AHHC服务后3天内采取了什么行动。此外，在家庭咨询后，AHHC医生将患者的病情严重程度分类为轻度（可用非处方药治疗）、中度（需要医院或诊所就诊）或重度（需要救护车运输）。在研究期间使用AHHC医疗服务的15，787名患者中，2128名完成了问卷调查（13.5%的应答率）。年龄≤15岁和16-64岁的个体是AHHC服务的最常见用户（≤15岁，71.4%; 16-64岁，26.8%）。在使用AHHC服务之前，46.4%的受访者表示，如果没有AHHC服务，他们会去艾德就诊（≤15岁，47.8%; 16-64岁，42.8%; ≥65岁，43.6%）。最初计划呼叫救护车的患者比例在较大年龄组中较高（≤15岁，1.1%; 16-64岁，6.0%; ≥65岁，20.5%）。在使用AHHC服务后，大多数患者（68.1%）在3天内没有去医院就诊;然而，在3天内去艾德就诊并叫救护车的患者比例随着病情的严重程度而增加。提高老年人和被评估为患有严重疾病的患者对AHHC医疗服务的认识，定期利用AHHC服务可能有助于减少艾德就诊和救护车使用。在线版本包含补充材料，可通过10.1186/s12873-021-00545-w获得。
After-hours house call (AHHC) medical services have been implemented in Japan to reduce ambulance use, as well as overcrowding at the emergency department (ED). Examining the pre-and post-home visit behaviors of those using AHHC medical services will provide insights into the usefulness of these services and help develop strategies to reduce ED visits and ambulance use further. This questionnaire-based study used data from anonymized medical records and internet-based questionnaires completed by patients who used AHHC medical services in Tokyo, Japan, between January 1 and December 31, 2019. The questionnaire comprised two questions: (1) What action would the patient have taken in the absence of AHHC services and (2) what action was taken within 3 days following the use of the AHHC services. In addition, following home consultations, AHHC doctors classified the patient’s illness severity as mild (treatable with over-the-counter medications), moderate (requires hospital or clinic visit), or severe (requires ambulance transportation). Of the 15,787 patients who used AHHC medical services during the study period, 2128 completed the questionnaire (13.5% response rate). Individuals aged ≤15 years and 16–64 years were the most common users of AHHC services (≤15 years, 71.4%; 16–64 years, 26.8%). Before using the AHHC service, 46.4% of the total respondents reported that they would have visited an ED had AHHC services not been available (≤15 years, 47.8%; 16–64 years, 42.8%; ≥65 years, 43.6%). The proportion of patients originally planning to call an ambulance was higher among those in the older age groups (≤15 years, 1.1%; 16–64 years, 6.0%; ≥65 years, 20.5%). After using the AHHC services, most patients (68.1%) did not visit a hospital within 3 days; however, the proportion of patients who visited an ED and called an ambulance within 3 days increased with the severity of illness. Increasing AHHC medical services awareness among older adults and patients assessed as having severe illnesses regularly availing of AHHC services may help reduce ED visits and ambulance use. The online version contains supplementary material available at 10.1186/s12873-021-00545-w.
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