Cargando…
Nonurgent patients in the emergency department? A French formula to prevent misuse
BACKGROUND: Overcrowding in emergency department (EDs) is partly due to the use of EDs by nonurgent patients. In France, the authorities responded to the problem by creating primary care units (PCUs): alternative structures located near hospitals. The aims of the study were to assess the willingness...
Autores principales: | , , , , , |
---|---|
Formato: | Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2010
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846926/ https://www.ncbi.nlm.nih.gov/pubmed/20230602 http://dx.doi.org/10.1186/1472-6963-10-66 |
_version_ | 1782179521154252800 |
---|---|
author | Gentile, Stéphanie Vignally, Pascal Durand, Anne-Claire Gainotti, Sabina Sambuc, Roland Gerbeaux, Patrick |
author_facet | Gentile, Stéphanie Vignally, Pascal Durand, Anne-Claire Gainotti, Sabina Sambuc, Roland Gerbeaux, Patrick |
author_sort | Gentile, Stéphanie |
collection | PubMed |
description | BACKGROUND: Overcrowding in emergency department (EDs) is partly due to the use of EDs by nonurgent patients. In France, the authorities responded to the problem by creating primary care units (PCUs): alternative structures located near hospitals. The aims of the study were to assess the willingness of nonurgent patients to be reoriented to a PCU and to collect the reasons that prompted them to accept or refuse. METHODS: We carried out a cross sectional survey on patients' use of EDs. The study was conducted in a French hospital ED. Patients were interviewed about their use of health services, ED visits, referrals, activities of daily living, and insurance coverage status. Patients' medical data were also collected. RESULTS: 85 patients considered nonurgent by a triage nurse were asked to respond to a questionnaire. Sex ratio was 1.4; mean age was 36.3 +/- 11.7 years. Most patients went to the ED autonomously (76%); one third (31.8%) had consulted a physician. The main reasons for using the ED were difficulty to get an appointment with a general practitioner (22.3%), feelings of pain (68.5%), and the availability of medical services in the ED, like imaging, laboratory tests, and drug prescriptions (37.6%). Traumatisms and wounds were the main medical reasons for going to the ED (43.5%). More than two-thirds of responders (68%) were willing to be reoriented towards PCUs. In the multivariate analysis, only employment and the level of urgency perceived by the patient were associated with the willingness to accept reorientation. Employed persons were 4.5 times more likely to accept reorientation (OR = 4.5 CI (1.6-12.9)). Inversely, persons who perceived a high level of urgency were the least likely to accept reorientation (OR = 0.9 CI (0.8-0.9). CONCLUSIONS: Our study provides information on the willingness of ED patients to accept reorientation and shows the limits of its feasibility. Alternative structures such as PCUs near the ED seem to respond appropriately to the growing demands of nonurgent patients. Reorientation, however, will be successful only if the new structures adapt their opening hours to the needs of nonurgent patients and if their physicians can perform specific technical skills. |
format | Text |
id | pubmed-2846926 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2010 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-28469262010-03-30 Nonurgent patients in the emergency department? A French formula to prevent misuse Gentile, Stéphanie Vignally, Pascal Durand, Anne-Claire Gainotti, Sabina Sambuc, Roland Gerbeaux, Patrick BMC Health Serv Res Research article BACKGROUND: Overcrowding in emergency department (EDs) is partly due to the use of EDs by nonurgent patients. In France, the authorities responded to the problem by creating primary care units (PCUs): alternative structures located near hospitals. The aims of the study were to assess the willingness of nonurgent patients to be reoriented to a PCU and to collect the reasons that prompted them to accept or refuse. METHODS: We carried out a cross sectional survey on patients' use of EDs. The study was conducted in a French hospital ED. Patients were interviewed about their use of health services, ED visits, referrals, activities of daily living, and insurance coverage status. Patients' medical data were also collected. RESULTS: 85 patients considered nonurgent by a triage nurse were asked to respond to a questionnaire. Sex ratio was 1.4; mean age was 36.3 +/- 11.7 years. Most patients went to the ED autonomously (76%); one third (31.8%) had consulted a physician. The main reasons for using the ED were difficulty to get an appointment with a general practitioner (22.3%), feelings of pain (68.5%), and the availability of medical services in the ED, like imaging, laboratory tests, and drug prescriptions (37.6%). Traumatisms and wounds were the main medical reasons for going to the ED (43.5%). More than two-thirds of responders (68%) were willing to be reoriented towards PCUs. In the multivariate analysis, only employment and the level of urgency perceived by the patient were associated with the willingness to accept reorientation. Employed persons were 4.5 times more likely to accept reorientation (OR = 4.5 CI (1.6-12.9)). Inversely, persons who perceived a high level of urgency were the least likely to accept reorientation (OR = 0.9 CI (0.8-0.9). CONCLUSIONS: Our study provides information on the willingness of ED patients to accept reorientation and shows the limits of its feasibility. Alternative structures such as PCUs near the ED seem to respond appropriately to the growing demands of nonurgent patients. Reorientation, however, will be successful only if the new structures adapt their opening hours to the needs of nonurgent patients and if their physicians can perform specific technical skills. BioMed Central 2010-03-15 /pmc/articles/PMC2846926/ /pubmed/20230602 http://dx.doi.org/10.1186/1472-6963-10-66 Text en Copyright ©2010 Gentile et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research article Gentile, Stéphanie Vignally, Pascal Durand, Anne-Claire Gainotti, Sabina Sambuc, Roland Gerbeaux, Patrick Nonurgent patients in the emergency department? A French formula to prevent misuse |
title | Nonurgent patients in the emergency department? A French formula to prevent misuse |
title_full | Nonurgent patients in the emergency department? A French formula to prevent misuse |
title_fullStr | Nonurgent patients in the emergency department? A French formula to prevent misuse |
title_full_unstemmed | Nonurgent patients in the emergency department? A French formula to prevent misuse |
title_short | Nonurgent patients in the emergency department? A French formula to prevent misuse |
title_sort | nonurgent patients in the emergency department? a french formula to prevent misuse |
topic | Research article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846926/ https://www.ncbi.nlm.nih.gov/pubmed/20230602 http://dx.doi.org/10.1186/1472-6963-10-66 |
work_keys_str_mv | AT gentilestephanie nonurgentpatientsintheemergencydepartmentafrenchformulatopreventmisuse AT vignallypascal nonurgentpatientsintheemergencydepartmentafrenchformulatopreventmisuse AT durandanneclaire nonurgentpatientsintheemergencydepartmentafrenchformulatopreventmisuse AT gainottisabina nonurgentpatientsintheemergencydepartmentafrenchformulatopreventmisuse AT sambucroland nonurgentpatientsintheemergencydepartmentafrenchformulatopreventmisuse AT gerbeauxpatrick nonurgentpatientsintheemergencydepartmentafrenchformulatopreventmisuse |