Emergency department visits for non-life-threatening conditions: evolution over 13 years in a Swiss urban teaching hospital

Diserens, Léonard; Egli, Lukas; Fustinoni, Sarah; Santos-Eggimann, Brigitte; Staeger, Philippe

doi:10.4414/smw.2015.14123

Cited by 23 publications

(36 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These two groups were 1.5 times more likely to present with a non-urgent condition than the rest of the study population. This finding is consistent with international studies from the United States [6,34], Canada [11], Switzerland [9,38], the United Kingdom [13], and Australia [8,39] all observing an over-representation in non-urgent presentations by younger populations. Consideration of why this over-representation is occurring may contribute to further understanding of the decision-making processes of young people and access to alternative services for this group.…”

Section: Plos Onesupporting

confidence: 90%

“…This includes people who present to the ED for simple examination, investigation or observation, the proportion found in this study is reflective of nationwide trends for this principle diagnostic group [32]. The significant increase may be explained by international research which clearly identifies the patient's perceived need for urgent medical attention as a major theme when investigating reasons for accessing ED services with non-urgent conditions [6,8,38]. The continued high proportion of patients who were discharged home and did not require specialist follow-up in this study raises questions around health literacy, health anxiety and timely access to alternative services.…”

Section: Increased Presentations With Non-urgent Mental Health Diagnomentioning

confidence: 99%

See 1 more Smart Citation

Socioeconomic disadvantage as a driver of non-urgent emergency department presentations: A retrospective data analysis

et al. 2020

View full text Add to dashboard Cite

Background Globally, emergency departments (EDs) are struggling to meet the service demands of their local communities. Across Australia, EDs routinely collect data for every presentation which is used to determine the ability of EDs to meet key performance indicators. This data can also be used to provide an overall picture of service demand and has been used by healthcare planners to identify local needs and inform service provision, thus, using ED presentations as a microcosm of the communities they serve. The aim of this study was to use ED presentation data to identify who, when and why people accessed a regional Australian ED with non-urgent conditions. Method and materials A retrospective data analysis of routinely collected ED data was undertaken. This included data obtained over a seven-year period (July 2009 to June 2016) in comparison with the Australian Bureau of Statistics census data. Analysis included descriptive statistics to identify the profile of non-urgent attendees and linear regression to identify trends in ED usage. Results This study revealed a consistently high demand for ED services by people with non-urgent conditions (54.1% of all presentations). People living in the most disadvantaged socioeconomic decile contributed to 36.8% of these non-urgent presentations while those under 25 years of age contributed to 41.1%. Diagnoses of mental health and behavioural issues and of non-specific symptoms significantly increased over the study period (p < 0.001) for both diagnostic groups.

show abstract

Section: Plos Onesupporting

confidence: 90%

Section: Increased Presentations With Non-urgent Mental Health Diagnomentioning

confidence: 99%

Socioeconomic disadvantage as a driver of non-urgent emergency department presentations: A retrospective data analysis

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Our programme theories did not include some issues which have been identified elsewhere: awareness of services, although only 3% of people reported this as an issue in one study; the convenience of the setting in terms of shorter distance to travel to an emergency department or GP out of hours service; health knowledge; geography in terms of rural and urban locations; not having a GP; patient misunderstanding of role of a service; the desire to take control through contacting a service; lower cost/financial considerations; and lack of transport . These did not become programme theories because they did not appear strongly within the included qualitative literature of patients' perceptions of clinically unnecessary use.…”

Section: Discussionmentioning

confidence: 95%

‘Clinically unnecessary’ use of emergency and urgent care: A realist review of patients' decision making

O’Cathain

Connell

Long

et al. 2019

Health Expectations

View full text Add to dashboard Cite

Background:Demand is labelled 'clinically unnecessary' when patients do not need the levels of clinical care or urgency provided by the service they contact.Objective: To identify programme theories which seek to explain why patients make use of emergency and urgent care that is subsequently judged as clinically unnecessary.Design: Realist review. Methods:Papers from four recent systematic reviews of demand for emergency and urgent care, and an updated search to January 2017. Programme theories developed using Context-Mechanism-Outcome chains identified from 32 qualitative studies and tested by exploring their relationship with existing health behaviour theories and 29 quantitative studies.Results: Six mechanisms, based on ten interrelated programme theories, explained why patients made clinically unnecessary use of emergency and urgent care: (a) need for risk minimization, for example heightened anxiety due to previous experiences of traumatic events; (b) need for speed, for example caused by need to function normally to attend to responsibilities; (c) need for low treatment-seeking burden, caused by inability to cope due to complex or stressful lives; (d) compliance, because family or health services had advised such action; (e) consumer satisfaction, because emergency departments were perceived to offer the desired tests and expertise when contrasted with primary care; and (f) frustration, where patients had attempted and failed to obtain a general practitioner appointment in the desired timeframe. Multiple mechanisms could operate for an individual. Conclusions:Rather than only focusing on individuals' behaviour, interventions could include changes to health service configuration and accessibility, and societal changes to increase coping ability. K E Y W O R D Semergency medicine, heath care seeking behaviour, patients, urgent care

show abstract

“…Wśród pacjentów zgłaszających się do SOR prezentują-cych niewielką urazowość najczęściej obserwowano osoby młode w wieku [11][12][13][14][15][16][17][18][19][20] …”

Section: Materiał I Metodyunclassified

“…Raport Najwyższej Izby Kontroli (NIK) wskazuje, że od 30 do 80% pacjentów SOR stanowią osoby, którym powinna być udzielona pomoc w ramach POZ, AOS lub nocnej i świątecznej pomocy doraźnej [4]. Czynnikami zwiększającymi prawdopodobieństwo zgłaszania się pacjentów w przypadkach niepilnych są: młody wiek pacjenta [5,6], samotność [7], przewlekła chorobowość [8,9], doznanie urazu [7], możliwość dotarcia do SOR w czasie krótszym niż 15 minut [7,9], okres weekendu [7], przeświadczenie pacjenta o szybkim uzyskaniu porady w SOR [10], brak satysfakcji z leczenia przez lekarza rodzinnego [5,11,12], brak możliwości telefonicznej konsultacji z POZ [11], ale również nieograniczony dostęp pacjenta do świadczeń opieki zdrowotnej finansowanych ze środków publicznych [8,9,13]. Pacjenci czę-sto zgłaszają się do SOR także za namową innych osób, najczęściej profesjonalistów związanych z ochroną zdrowia, których pacjenci postrzegają jako autorytety w dziedzinie medycyny (lekarz, pielęgniarka) [5,10].…”

unclassified

Analysis of the patients’ with minor injuries attendance to the Emergency Department

Szwamel¹,

Kurpas²

2016

fmpcr

View full text Add to dashboard Cite

A -przygotowanie projektu badania, B -zbieranie danych, C -analiza statystyczna, D -interpretacja danych, E -przygotowanie maszynopisu, F -opracowanie piśmiennictwa, G -pozyskanie funduszy Wstęp. Brak skutecznych rozwiązań systemowych w zakresie opieki podstawowej i długi czas oczekiwania na konsultację w ramach ambulatoryjnej opieki specjalistycznej są przyczyną zgłoszeń do SOR pacjentów nie wymagających zastosowania procedur ratowniczych. Możliwość szybkiego dotarcia do SOR oraz nieograniczony dostęp pacjenta do świad-czeń opieki zdrowotnej finansowanych ze środków publicznych zwiększają prawdopodobieństwo zgłaszania się do SOR pacjentów w przypadkach niepilnych. Cel pracy. Analiza zgłaszalności do SOR pacjentów z niewielkimi urazami. Materiał i metody. Badanie objęło 155 pacjentów Kędzierzyńsko-Kozielskiego SOR z niewielkimi urazami. Zastosowano sondaż diagnostyczny z wykorzystaniem autorskiego kwestionariusza ankiety. Wyniki. Pacjenci z niewielką urazowością to najczęściej osoby w wieku 11-40 lat (66,7%; 100) zgłaszające się do SOR samodzielnie (92,7%; 139), najczęściej z urazami kończyn (72,7%; 109) powstałymi wskutek upadku, potknięcia, poślizgnięcia, uderzenia (78,7%; 118) w czasie trzech godzin od wystąpienia urazu (57,3%; 87) z umiarkowanie nasilonymi dolegliwościa-mi. Badani sądzą, że niewielkie urazy wymagają diagnostyki radiologicznej (38,7%; 58) i konsultacji specjalistycznej (34%; 51), a SOR jest najbardziej właściwym miejscem do ich leczenia (45,3%; 68). Nie podejmowanie przez tych pacjentów leczenia w POZ (85,3%; 128) nie jest tożsame z niedowierzaniem pacjenta w możliwości leczenia przez lekarza rodzinnego (OR = 1,46 przy 95% CI [0,52; 4,55]; p = 0,49). Wnioski. Istotna jest edukacja pacjentów na temat roli SOR w systemie ochrony zdrowia, możliwości zaopatrywania niewielkich urazów w POZ, samoopieki i samopielęgnacji w zakresie postępowania w przypadku niewielkiej urazowości oraz szkodliwego wpływu nadmiaru promieni RTG na ludzki organizm. Słowa kluczowe: podstawowa opieka zdrowotna, oddział ratunkowy, urazy.Background. The lack of effective system solutions in the field of primary care, long waiting times for outpatient consultation in the framework of specialist care are the cause of those patient's applications to ED who do not require the use of emergency procedures. The ability to quickly get to ED and unrestricted patient access to health care services financed from public funds increase the likelihood of reporting to ED by the patients in non-urgent cases. Objectives. Analysis of the patient's attendance with minor injuries to ED. Material and methods. 155 patients of ED in Kędzierzyn-Koźle were examined by a diagnostic survey based on a copyright questionnaire. Results. Patients with minor injuries are generally people aged 11-40 years (66.7%; 100) self-referred to ED (92.7%; 139), with injuries of the extremities (72.7%; 109) that arise from falling, tripping, slipping, impaction (78.7%;118) during three hours of the onset of injury (57.3%; 87) with moderate symptoms. Respondents believ...

show abstract

Emergency department visits for non-life-threatening conditions: evolution over 13 years in a Swiss urban teaching hospital

Abstract: The number of visits for non-life-threatening consultations continue to increase. Our ED is used by a large proportion of patients as a convenient alternative source of primary care.

Cited by 23 publications

References 35 publications

Socioeconomic disadvantage as a driver of non-urgent emergency department presentations: A retrospective data analysis

Socioeconomic disadvantage as a driver of non-urgent emergency department presentations: A retrospective data analysis

‘Clinically unnecessary’ use of emergency and urgent care: A realist review of patients' decision making

Analysis of the patients’ with minor injuries attendance to the Emergency Department

Contact Info

Product

Resources

About