Emergency outpatient services in the city of Berlin: factors for appropriate use and predictors for hospital admission

David, Matthias; Schwartau, I.; Pant, Hans Anand; Borde, Theda

doi:10.1097/01.mej.0000228451.15103.89

Cited by 36 publications

(33 citation statements)

References 21 publications

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“…Researchers have used varying definitions of urgency and non‐urgency, which makes an appraisal of the present findings difficult. Nonetheless, studies with a similar approach have reported comparable results . For example, our research group previously developed an inappropriateness index for ED or GED utilization that combined both patient and system perspectives, reporting that ethnicity was not a significant predictor for inappropriate use of EDs, analogous to the current findings based on a composite index.…”

Section: Discussionsupporting

confidence: 69%

The role of acculturation in migrants’ use of gynecologic emergency departments

Schwachenwalde

Sauzet

Razum

et al. 2020

Intl J Gynecology & Obste

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Objective To examine whether acculturation of migrant patients is a predictor of non‐urgent use of gynecologic emergency departments (GEDs). Methods A cross‐sectional study based on standardized questionnaire interviews among migrant (n=477) and non‐migrant (n=246) women attending a GED in Berlin, Germany, between 2017 and 2018. Non‐urgent GED use was defined by health system (e.g., no hospital admission) or patient (e.g., low subjective urgency) criteria. Acculturation was assessed by the Frankfurt Acculturation Scale. Logistic regressions were calculated with non‐migrants as the reference. Results Relative to migrants, low acculturation of migrants had no significant effect on overall non‐urgent GED use. However, low acculturation was a significant predictor of non‐urgent use if defined only by health system criteria (adjusted odds ratio [AOR], 1.58; 95% confidence interval [CI], 1.02–2.44; P=0.041). Inversely, low acculturation had a significant negative effect on non‐urgent use if defined only by patient criteria (AOR, 0.58; 95% CI, 0.38–0.90; P=0.014). Conclusion Low‐acculturated migrants were more prone to non‐urgent GED use as defined by health system criteria, and might have a distorted perception of urgency. According to their perception, however, low‐acculturated patients showed appropriate GED use for urgent complaints, indicating that they are insufficiently cared for by the healthcare system.

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Section: Discussionsupporting

confidence: 69%

The role of acculturation in migrants’ use of gynecologic emergency departments

Schwachenwalde

Sauzet

Razum

et al. 2020

Intl J Gynecology & Obste

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“…The interviews were held with those patients -both walking and not walking -who were considered capable of answering, aware of the reality surrounding them [52] and not younger than 15 [1,13]. In the A&ED the interviews were held with all the patients who, regardless of the urgency code they had been attributed, were considered by the nurse in charge of triage as possible non-urgent patients.…”

Section: Methodsmentioning

confidence: 99%

Why non-urgent patients choose emergency over primary care services? Empirical evidence and managerial implications

Lega

Mengoni²

2008

Health Policy

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“…Older patients have higher rates of hospital admission, and longer hospital stays than the general population, which accounts for a disproportionate number of hospital bed days [1]. Moreover, there are even higher rates of hospital admissions of older people who live in residential aged care facilities [2].…”

Section: Introductionmentioning

confidence: 99%

Inappropriate hospital admission: interaction between patient age and co-morbidity

et al. 2011

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The aim of the study is to determine the prevalence of inappropriate admission, and to identify the factors that influence appropriateness of hospital admission. Data were prospectively collected from all 345 consecutive patients admitted during the period of 1 month for acute hospital care at a 110-bed division of internal medicine using socio-demographic and medical information. Statistical analyses included χ2 tests, t tests, and logistic regression analyses. According to the European version of the Appropriateness Evaluation Protocol of hospital admission, 28.1% of medical admissions for acute care in the Central Hospital of Bolzano, Italy, have been classified as inappropriate. Factors that reduced appropriateness included female gender, age and chronic illness that are significantly associated with appropriateness of medical admission, whereas time of day or day of week of the emergency department (ED) visit does not influence appropriateness. In multiple logistic regression analyses, age and co-morbidity are not independently related to appropriateness, however, when tested for interaction, inappropriateness is significantly more frequent at a young age in the absence of co-morbidities, and, numerically most relevant, in elderly patients presenting with co-morbidities. In this evaluation of a single centre North Italian hospital admission, co-morbidity turns out to be an important age-dependent determinant of appropriateness. Although in the young age group, co-morbidity increases the likelihood of being appropriately admitted, the presence of chronic illness in the elderly increases the risk of inappropriate hospital use.

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Emergency outpatient services in the city of Berlin: factors for appropriate use and predictors for hospital admission

Cited by 36 publications

References 21 publications

The role of acculturation in migrants’ use of gynecologic emergency departments

The role of acculturation in migrants’ use of gynecologic emergency departments

Why non-urgent patients choose emergency over primary care services? Empirical evidence and managerial implications

Inappropriate hospital admission: interaction between patient age and co-morbidity

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