Is subjectively perceived treatment urgency of patients in emergency departments associated with self-reported health literacy and the willingness to use the GP as coordinator of treatment? Results from the multicentre, cross-sectional, observational study PiNo Bund

Abstract

ObjectivesAim of this study was to analyse if subjectively perceived treatment urgency of patients in emergency departments is associated with self-reported health literacy and the willingness to use the general practitioner (GP) as coordinator of treatment.DesignA multicentre, cross-sectional, observational study.SettingEmergency departments in five hospitals. Each hospital was visited 14 times representing two 8-hour shifts on each day of the week. Calendar dates were randomly assigned.ParticipantsAll patients of legal age registered at the emergency department or hospital reception desk. Exclusion criteria included immediate or very urgent need of treatment, high level of symptom burden and severe functional impairments in terms of hearing, vision and speech. We conducted standardised personal interviews. Additionally, clinical data were extracted from patient records.Primary and secondary outcome measuresOur target variable was subjectively perceived treatment urgency. Predictor variables included age, sex, education, health-related quality of life (EuroQol Five-Dimension Scale, value set UK), anxiety and depression (Hospital Anxiety and Depression Scale), somatic symptoms (Patient Health Questionnaire, 15 items version), self-reported health literacy (European Health Literacy Questionnaire, 16 questions version) and the commitment to the GP (Fragebogen zur Intensität der Hausarztbindung, ‘F-HaBi’). Data were analysed by multilevel, multivariable linear regression adjusted for random effects at the hospital level.ResultsOur sample comprised 276 patients with a mean age of 50.1 years and 51.8% women. A low treatment urgency (defined as 0–5 points on a Numerical Rating Scale) was reported by 111 patients (40.2%). In the final model, lower subjective treatment urgency was associated with male sex (β=0.84; 95% CI 0.11/1.57, p=0.024), higher health-related quality of life (−2.27 to –3.39/−1.15, p<0.001), lower somatic symptoms score (0.09, 0.004/0.17, p=0.040), higher anxiety score (−0.13 to –0.24/−0.01, p=0.027) and lower commitment to the GP (0.08, 0.01/0.14, p=0.029).ConclusionsA lower level of subjectively perceived treatment urgency was predicted by a lower willingness to use the GP as coordinator of treatment. Self-reported health literacy did not predict the patients’ urgency rating.

Patient satisfaction with computer-assisted structured initial assessment facilitating patient streaming to emergency departments and primary care practices: results from a cross-sectional observational study accompanying the DEMAND intervention in Germany

“…An insurance claims data based analysis of the age distribution in outpatient emergency patients showed a comparable mean and variance of age as in our study [ 27 ]. However, in two studies observing patients with unselected, non-urgent conditions, the distribution of sex was more balanced than in our study [ 10 , 28 ].…”

“…Grouped into three categories, 50% of our population had sufficient, 32.8% had problematic, and 17.0% had inadequate health literacy. The rates of problematic and inadequate health literacy were higher than in the general population [44], but comparable to another study in the non-urgent emergency department setting [28]. We observed that a lower health literacy was associated with reduced patient satisfaction.…”

Association between patient-related factors and avoided consultations due to fear of COVID-19 during the first lockdown in northern Germany: Results of a cross-sectional observational study

“…We conducted a retrospective, cross-sectional observational study based on personal standardized interviews in the Central Emergency Clinic of the University Medical Center Hamburg-Eppendorf. The study was part of the “PiNo” studies [15] , [16] , which were approved by the Ethics Committee of the Hamburg Medical Association on 22 July 2015 and amended on 7 March 2017 and 30 December 2019 (approval no. PV4993).…”

“…The aim of the “PiNo” studies was to characterize patients attending emergency departments, who do not require urgent treatment, with respect to their sociodemographic features, health status, and reasons for attending an emergency department. Cross-sectional observational data was collected in different hospitals as part of the “PiNo” studies [15] , [16] .…”