Associations between perceived discrimination and health status among frequent Emergency Department users

Baggio, Stéphanie; Iglesias, Katia; Burnand, Bernard; Ruggeri, Ornella; Wasserfallen, Jean‐Blaise; Moschetti, Karine; Staeger, Philippe; Alary, Séverine; Allen, Marina Canepa; Daeppen, Jean‐Bernard; Bodenmann, Patrick

doi:10.1097/mej.0000000000000311

Cited by 19 publications

(16 citation statements)

References 21 publications

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“…A similar Black-by-wealth interaction was found for reports of discrimination at least a few times a year (eTable 4 in the supplement). setting has been associated with worse health, 27 lower satisfaction with health care, 28 and lower utilization of health services. 29 Patient-reported discrimination is of intrinsic importance, since internal appraisal is associated with behavioral responses and is a critical component in predicting biological stress responses.…”

Section: Resultsmentioning

confidence: 99%

Trends for Reported Discrimination in Health Care in a National Sample of Older Adults with Chronic Conditions

et al. 2017

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Section: Resultsmentioning

confidence: 99%

Trends for Reported Discrimination in Health Care in a National Sample of Older Adults with Chronic Conditions

et al. 2017

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“…quality of life and the perception of discrimination 24 ). Control group participants also received the CM team contact information, and anyone who contacted the team was eligible to receive CM services after the study.…”

Section: Intervention and Control Groupsmentioning

confidence: 99%

Case Management may Reduce Emergency Department Frequent use in a Universal Health Coverage System: a Randomized Controlled Trial

et al. 2016

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BACKGROUND: Frequent emergency department (ED) users account for a disproportionately high number of ED visits. Studies on case management (CM) interventions to reduce frequent ED use have shown mixed results, and few studies have been conducted within a universal health coverage system. OBJECTIVE: To determine whether a CM intervention--compared to standard emergency care-reduces ED attendance. DESIGN: Randomized controlled trial. PARTICIPANTS: Two hundred fifty frequent ED users (5 or more visits in the prior 12 months) who visited a public urban ED at the Lausanne University Hospital between May 2012 and July 2013 were allocated to either an intervention (n = 125) or control (n = 125) group, and monitored for 12 months. INTERVENTIONS: An individualized CM intervention consisting of concrete assistance in obtaining income entitlements, referral to primary or specialty medical care, access to mental health care or substance abuse treatment, and counseling on at-risk behaviors and health care utilization (in addition to standard care) at baseline and 1, 3, and 5 months. MAIN MEASURES: We used a generalized linear model for count data (negative binomial distribution) to compare the number of ED visits during the 12-month follow-up between CM and usual care, from an intention-to-treat perspective.KEY RESULTS: At 12 months, there were 2.71 (±0.23) ED visits in the intervention group versus 3.35 (±0.32) visits among controls (ratio = 0.81, 95 % CI = 0.63; 1.02). In the multivariate model, the effect of the CM intervention on the number of ED visits approached statistical significance (b = −0.219, p = 0.075). The presence of poor social determinants of health was a significant predictor of ED use in the multivariate model (b = 0.280, p = 0.048). CONCLUSIONS: CM may reduce ED use by frequent users through an improved orientation to the health care system. Poor social determinants of health significantly increase use of the ED by frequent users.

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“…Some frequent attenders also experienced actual discrimination, in agreement with previous studies. Baggio et al (2017) found that over 30% of frequent attenders experienced some kind of discrimination from healthcare professionals, with disease, physical appearance, nationality, and language being the most common bases for discrimination. They also found that perceived discrimination was associated with poor self-reported health.…”

Section: Discussionmentioning

confidence: 99%

Frequent attenders' experiences of encounters with healthcare personnel: A systematic review of qualitative studies

Huhtakangas

Tuomikoski

Kyngäs

et al. 2020

Nursing & Health Sciences

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Rather than measure demographic factors such as socioeconomics, the aim of this study was to examine the lived experience of frequent attenders by synthesizing findings on their encounters with healthcare personnel. The Scopus, CINAHL, Psy-cARTICLES, and PubMed (Medline) databases were searched in May 2020 in order to screen studies by title and abstract (n = 1794) and full-text (n = 20). Findings from the included studies (n = 6) were then pooled using meta-aggregation, yielding the following results: difficulties in resolving frequent attenders' situations may create "service circles," frustrating patients with their situation; frequent attenders' own expertise regarding their condition should be recognized and valued alongside that of healthcare professionals when performing collaborative care; a lack of empathy and disparagement may make frequent attenders feel misunderstood and unappreciated; frequent attenders should be recognized as individuals by taking their circumstances into account and providing support accordingly. Frequent attenders' experiences demonstrate the importance of shared decision-making, continuity of care, and acknowledging these patients' individual circumstances. Identifying the variety of frequent attenders' service needs by synthesizing their experiences is a practical way of organizing patient-centered healthcare services.

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Associations between perceived discrimination and health status among frequent Emergency Department users

Cited by 19 publications

References 21 publications

Trends for Reported Discrimination in Health Care in a National Sample of Older Adults with Chronic Conditions

Trends for Reported Discrimination in Health Care in a National Sample of Older Adults with Chronic Conditions

Case Management may Reduce Emergency Department Frequent use in a Universal Health Coverage System: a Randomized Controlled Trial

Frequent attenders' experiences of encounters with healthcare personnel: A systematic review of qualitative studies

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