Psychological distress in frequent users of primary health care and emergency departments: a scoping review

Margo-Dermer, Eva; Dépelteau, Andréa; Girard, Ariane; Hudon, Catherine

doi:10.1016/j.puhe.2019.03.024

Cited by 9 publications

(8 citation statements)

References 31 publications

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“…For EDs outside the US, frequent ED users were more likely to be younger and have chronic illnesses compared to non-frequent ED users [8]. Significant associations have also been reported between frequent ED users and asthma [9], psychological distress [10,11], and substance use [4,12]. Other studies have suggested that a misunderstanding of medical necessity and access issues (e.g., ease, timing, geography) are reasons that frequent users present to EDs [13].…”

Section: Introductionmentioning

confidence: 99%

Frequent users of emergency departments and patient flow in Alberta and Ontario, Canada: an administrative data study

Chen

Fielding

et al. 2020

BMC Health Serv Res

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Background This paper describes and compares patient flow characteristics of adult high system users (HSUs) and control groups in Alberta and Ontario emergency departments (EDs), Canada. Methods Annual cohorts of HSUs were created by identifying patients who made up the top 10% of ED users (by count of ED presentations) in the National Ambulatory Care Reporting System during 2011–2016. Random samples of patients not in the HSU groups were selected as controls. Presentation (e.g., acuity) and ED times (e.g., time to physician initial assessment [PIA], length of stay) data were extracted and described. The length of stay for 2015/2016 data was decomposed into stages and Cox models compared time between stages. Results There were 20,343,230 and 18,222,969 ED presentations made by 7,032,655 and 1,923,462 individuals in the control and HSU groups, respectively. The Ontario groups had higher acuity than the Alberta groups: about 20% in the Ontario groups were from the emergent level whereas Alberta had 11–15%. Time to PIA was similar across provinces and groups (medians of 60 min to 67 min). Lengths of stay were longest for Ontario HSUs (median = 3 h) and shortest for Alberta HSUs (median = 2.2 h). HSUs had shorter times to PIA (hazard ratio [HR] = 1.03; 95% confidence interval [CI] 1.02,1.03), longer times from PIA to decision (HR = 0.84; 95%CI 0.84,0.84), and longer times from decision to leaving the ED (HR = 0.91; 95%CI 0.91,0.91). Conclusions Ontario HSUs had higher acuity and longer ED lengths of stay than the other groups. In both provinces, HSU had shorter times to PIA and longer times after assessment.

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Section: Introductionmentioning

confidence: 99%

Frequent users of emergency departments and patient flow in Alberta and Ontario, Canada: an administrative data study

Chen

Fielding

et al. 2020

BMC Health Serv Res

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“…In their concept analysis of frequent attendance, Kivelä et al (4) highlighted how the symptoms that FAs report negatively influence their health status and quality of life. Similarly, psychosocial distress has been found to be common among FAs (27). The feeling of not being able to cope with one’s situation is another central reason for consultations (5).…”

Section: Discussionmentioning

confidence: 92%

“…Depression did not seem to be associated with short‐term FAs or any FAs in the performed analyses, which suggest that depression is a distinct attribute of long‐term FAs. According to a recent review, psychosocial distress is significantly associated with frequent attendance (27). However, six of the seven studies were cross‐sectional, with only one adopting a longitudinal design, leaving it unclear whether psychosocial distress is a longitudinal predictor of frequent attendance.…”

Section: Discussionmentioning

confidence: 99%

Differentiating middle‐aged long‐term and short‐term frequent attenders by means of the Northern Finland Birth Cohort 1966 Study

Huhtakangas

Kyngäs

Bloigu

et al. 2020

Scandinavian Caring Sciences

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Background Frequent attendance is largely a temporary phenomenon, but only few previous studies have made a distinction between long‐term frequent attenders (FAs) and short‐term FAs. Aims The aim of this study is to compare the characteristics of middle‐aged long‐term FAs and short‐term FAs. Methods Data from a large Northern Finland Birth Cohort 1966 studyʼs (NFBC1966) 46‐year follow‐up study (performed in 2012, N = 10 321) were used. The participants (n = 4390) had used public primary healthcare (PPHC) services at least once during 2013–2016 according to Finnish national register data on outpatient visits. A FA was considered a patient who had used PPHC services ≥8 times during 1 year. A long‐term FA: a patient who was a FA in at least 3 years during 2013–2016. A short‐term FA: a patient who was a FA in 1 or 2 years in 2013–2016. Cross‐tabulation, Pearson’s chi‐squared test, Mann–Whitney U test, and univariate and multivariate binary logistic regression analyses were used. Results Of the 4390 participants, 132 (3.0%) were long‐term FAs, 645 (14.7%) were short‐term FAs, and 3613 (82.3%) were non‐FAs. During 2013–2016, long‐term FAs accounted for 34.8% of PPHC visits, while short‐term FAs accounted 15.4%. Compared to short‐term FAs, depression and high income (preventive attribute) were associated with long‐term FAs. Female gender and managing usual activities were associated with short‐term FAs. Poor self‐reported health was associated with both long‐term FAs and short‐term FAs but increased the risk of being a long‐term FA over three times compared to short‐term FAs. Conclusions Middle‐aged long‐term FAs and short‐term FAs have distinct characteristics; namely, depression and high income differentiate long‐term FAs from short‐term FAs. Poor self‐reported health was associated with long‐term FAs in particular. In order to identify FAs with prolonged service needs and to develop far‐reaching interventions, the focus of research should be on long‐term FAs.

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“…In this sense, the current data showed that people working and quite going out had a lower perception of stress, whereas individuals who had lost their jobs had a higher stress perception. Therefore, the economic impact of the COVID-19 situation in the area under evaluation could have a deleterious effect on people’s health since stress is widely related to both physical and psychological diseases (even if such a differentiation could be made) [43-46] Moreover, psychological distress is prevalent in frequent users of primary health care and emergency departments and has a significant association with frequent use [47]. It suggests that the increase of distress due to the COVID-19 could considerably increase health expenses.…”

Section: Discussionmentioning

confidence: 99%

Does living close to petrochemical complex increase the adverse psychological effects of COVID-19 lockdown?

Vicens

Heredia

Pérez

et al. 2020

Preprint

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The petrochemical industry has made possible the economic development of many local communities, increasing the employment opportunities and generating a complex network of secondary industries closely related to those. However, it is known that petrochemical industries emit air pollutants, which are related to different negative effects on mental health. In addition, many people around the world are being exposed to highly stressful situations derived from the COVID-19 pandemic and the lockdown adopted by the national and regional governments. The present study was aimed at analysing the possible differential effects on different psychological outcomes (stress, anxiety, depression and emotional regulation strategies) derived from the COVID-19 pandemic and the consequent lockdown in individuals living near an important petrochemical complex and subjects living in other areas, non-exposed to the characteristic environmental pollutants emitted by this kind of complexes. The sample was composed by 1607 subjects which respond a questionnaire developed ad hoc about the confinement conditions, the Perceived Stress Scale (PSS), the Hospital Anxiety and Depression Scale (HADS), the Barratt Impulsivity Scale (BIS) and the Emotional Regulation Questionnaire (ERQ). The results indicated that people living closer to petrochemical complexes reported greater risk perception. However, no significant relationships between psychological variables and proximity to the focus were detected when compared people living near to or far away from a chemical/petrochemical complex. Regarding the adverse psychological effects of the first lockdown due to COVID-19 on the general population in Catalonia, we can conclude that the lockdown conditions included in this survey were mainly related to changes in the impulsivity levels of participants. However, we can also suggest that the economic effects are going to be harder than those initially detected in this study. More studies are necessary to corroborate our results.Author ContributionsConceptualization: Paloma Vicens, Luis Heredia, José L. Domingo, Margarita TorrenteFunding Acquisition: José L. DomingoData Curation and Formal Analysis: Paloma Vicens, Luis Heredia, Edgar Bustamante, Yolanda Pérez, Margarita TorrenteMethodology: Paloma Vicens, Luis Heredia, Margarita TorrenteWriting-original draft: Paloma Vicens, Luis HerediaWriting- review and editing: Paloma Vicens, Luis Heredia, Yolanda Pérez, José L. Domingo, Margarita Torrente

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Psychological distress in frequent users of primary health care and emergency departments: a scoping review

Cited by 9 publications

References 31 publications

Frequent users of emergency departments and patient flow in Alberta and Ontario, Canada: an administrative data study

Frequent users of emergency departments and patient flow in Alberta and Ontario, Canada: an administrative data study

Differentiating middle‐aged long‐term and short‐term frequent attenders by means of the Northern Finland Birth Cohort 1966 Study

Does living close to petrochemical complex increase the adverse psychological effects of COVID-19 lockdown?

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