Rate of Use of Referrals in the Emergency Department
Rate of Use of Referrals in the Emergency Department
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DOI：
10.1177/097206340901200105
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发表时间：
2010-01-01
影响因子：
2.3
通讯作者：
Downey, La Vonne A.
中科院分区：
文献类型：
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作者：
Downey, La Vonne A.
本文的目的是：第一，以确定转诊完成率的初级保健医生（PCP）在急诊科（艾德）的病人谁是目前没有PCP。第二个目标是确定的原因，由个人谁没有使用的转介gived.The方法在本文中使用的是：回顾性研究，看看谁使用转介给他们在艾德在为期六个月的ED为基础的试点计划。然后进行了第二次前瞻性研究，使用电话调查;联系那些没有使用转介的人，这有助于确定不使用的原因。该研究获得了机构审查委员会（IRB）的批准。本文的结果表明，基于性别存在显著差异（p = 0.001）。男性占调查总人口的48%，与女性相比，他们只有9%的时间使用转诊。女性占答复者总数的52%，在42%的时间里使用转诊。基于服务支付方式，也存在显著差异（p = 0.01）。支付方式有多种，51%为自费，30%为公共支付，18%为私人支付。自付类别的人有43%不使用，而公共支付者为30%，私人支付者为7%。根据疾病类型、年龄和/或教育程度，没有显著差异。不使用转诊服务的原因是：25%的人不记得曾得到转诊服务; 14%的人英语水平不高，无法理解转诊服务; 10%的人认为转诊地点不方便; 10%的人报告健康状况有所改善。尽管病人被告知医疗保健提供者是免费的，但这受到了保险状况的影响。第二个因素是性别，女性更有可能使用所提供的转介。不使用的原因也是多方面的，最大比例的人（25%）不记得他们在艾德被转诊，14%的人有语言障碍影响使用，10%的人认为很难到达该地点，10%的人说他们的病情已经改善，因此不需要转诊。
The objectives of this article are: First, to determine the rate of referral completions for primary care physicians (PCPs) given out in the emergency department (ED) to the patients who are present without a PCP. The second objective is to determine the reasons given by the individuals who did not use the referrals given.The methods used during this article are: A retrospective study looking at who uses the referrals given to them in the ED during a six month ED-based pilot programme. A second prospective study using a phone survey was then done; those who did not use the referrals were contacted, which helped in determining the reasons for the non-usage. The study was approved by the Institutional Review Board (IRB).The results of this article indicate that there was a significant difference based on gender (p = 0.001). Males, who made up 48 per cent of the total survey population, used referrals only 9 per cent of the time as compared to females. Females, at 52 per cent of the total respondents, used referrals 42 per cent of the time. There was also a significant difference (p = 0.01) based on method of payment for services. The type of payment was mixed, with 51 per cent self-pay, 30 per cent public and 18 per cent private. Those in the category of self-pay had 43 per cent non-usage as compared to 30 per cent of those with public and 7 per cent of the private payers. There was no significant difference based on the type of illness, age and/or education. The reasons given for not using referrals were: 25 per cent did not remember being given a referral; 14 per cent did not speak English well enough to understand referrals; for 10 per cent the location was inconvenient; and 10 per cent reported improvement in health condition.The usage of referrals was affected by several factors. It was affected by the insurance status, despite the patient being told that the health care provider was free of charge. The second factor was gender, with females being more likely to use the referrals given. The reasons given for non-usage were also multidimensional, with the largest percentage (25 per cent) not remembering that they were given referrals in the ED, 14 per cent having language barriers that affected use, 10 per cent finding the location difficult to reach and 10 per cent stating their condition had improved, thus not needing the referral.