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Self-referrals in the emergency department: reasons why patients attend the emergency department without consulting a general practitioner first—a questionnaire study

BACKGROUND: To influence self-referral, it is crucial to know a patient’s motives to directly visit the emergency department (ED). The goal of this study is to examine motives for self-referral to the ED and compare these motives in relation to appropriateness. METHODS: All self-referred patients vi...

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Autores principales: Kraaijvanger, Nicole, Rijpsma, Douwe, van Leeuwen, Henk, Edwards, Michael
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4671987/
https://www.ncbi.nlm.nih.gov/pubmed/26644131
http://dx.doi.org/10.1186/s12245-015-0096-x
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author Kraaijvanger, Nicole
Rijpsma, Douwe
van Leeuwen, Henk
Edwards, Michael
author_facet Kraaijvanger, Nicole
Rijpsma, Douwe
van Leeuwen, Henk
Edwards, Michael
author_sort Kraaijvanger, Nicole
collection PubMed
description BACKGROUND: To influence self-referral, it is crucial to know a patient’s motives to directly visit the emergency department (ED). The goal of this study is to examine motives for self-referral to the ED and compare these motives in relation to appropriateness. METHODS: All self-referred patients visiting the ED of a Dutch hospital over four separate months in a 1-year period were included. Patients were handed questionnaires that included questions on their reasons to visit the ED directly and where they would seek medical help next time. Additionally, the motives of patients that either appropriately or inappropriately visited the ED were compared. In a previous study on the same patient cohort, the appropriateness of the ED visits was determined using predefined criteria. RESULTS: A total of 3196 self-referred patients were included, and 48.9 % completed the questionnaires. The majority of patients (28.0 %) attended the ED without a referral because they thought they would get help faster; the next reason was the easier access to radiologic and laboratory investigations (answered by 23.8 %); and the third was the symptoms were considered too severe to visit a general practitioner (GP) (answered by 22.7 %). The majority (78.5 %) would attend the ED the next time they are faced with similar symptoms. Appropriate visits were significantly more seen in females, elderly, and patients in higher triage categories. Patients who expect investigations are necessary, think their symptoms are too severe to visit a GP, or would return to the ED next time were more often appropriately visiting the ED. CONCLUSIONS: The choice of patients to self-refer to an ED is often an explicate decision. Patients are looking for specialist help and want fast and easy access to radiologic and laboratory investigations. Even though the primary care network is well developed in the Netherlands, the reasons for self-referral are similar to the reasons found in previous literature based in other countries. Patients who visit the ED because of health concerns visit the ED more often appropriately than patients visiting for practical reasons.
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spelling pubmed-46719872015-12-17 Self-referrals in the emergency department: reasons why patients attend the emergency department without consulting a general practitioner first—a questionnaire study Kraaijvanger, Nicole Rijpsma, Douwe van Leeuwen, Henk Edwards, Michael Int J Emerg Med Original Research BACKGROUND: To influence self-referral, it is crucial to know a patient’s motives to directly visit the emergency department (ED). The goal of this study is to examine motives for self-referral to the ED and compare these motives in relation to appropriateness. METHODS: All self-referred patients visiting the ED of a Dutch hospital over four separate months in a 1-year period were included. Patients were handed questionnaires that included questions on their reasons to visit the ED directly and where they would seek medical help next time. Additionally, the motives of patients that either appropriately or inappropriately visited the ED were compared. In a previous study on the same patient cohort, the appropriateness of the ED visits was determined using predefined criteria. RESULTS: A total of 3196 self-referred patients were included, and 48.9 % completed the questionnaires. The majority of patients (28.0 %) attended the ED without a referral because they thought they would get help faster; the next reason was the easier access to radiologic and laboratory investigations (answered by 23.8 %); and the third was the symptoms were considered too severe to visit a general practitioner (GP) (answered by 22.7 %). The majority (78.5 %) would attend the ED the next time they are faced with similar symptoms. Appropriate visits were significantly more seen in females, elderly, and patients in higher triage categories. Patients who expect investigations are necessary, think their symptoms are too severe to visit a GP, or would return to the ED next time were more often appropriately visiting the ED. CONCLUSIONS: The choice of patients to self-refer to an ED is often an explicate decision. Patients are looking for specialist help and want fast and easy access to radiologic and laboratory investigations. Even though the primary care network is well developed in the Netherlands, the reasons for self-referral are similar to the reasons found in previous literature based in other countries. Patients who visit the ED because of health concerns visit the ED more often appropriately than patients visiting for practical reasons. Springer Berlin Heidelberg 2015-12-07 /pmc/articles/PMC4671987/ /pubmed/26644131 http://dx.doi.org/10.1186/s12245-015-0096-x Text en © Kraaijvanger et al. 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Research
Kraaijvanger, Nicole
Rijpsma, Douwe
van Leeuwen, Henk
Edwards, Michael
Self-referrals in the emergency department: reasons why patients attend the emergency department without consulting a general practitioner first—a questionnaire study
title Self-referrals in the emergency department: reasons why patients attend the emergency department without consulting a general practitioner first—a questionnaire study
title_full Self-referrals in the emergency department: reasons why patients attend the emergency department without consulting a general practitioner first—a questionnaire study
title_fullStr Self-referrals in the emergency department: reasons why patients attend the emergency department without consulting a general practitioner first—a questionnaire study
title_full_unstemmed Self-referrals in the emergency department: reasons why patients attend the emergency department without consulting a general practitioner first—a questionnaire study
title_short Self-referrals in the emergency department: reasons why patients attend the emergency department without consulting a general practitioner first—a questionnaire study
title_sort self-referrals in the emergency department: reasons why patients attend the emergency department without consulting a general practitioner first—a questionnaire study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4671987/
https://www.ncbi.nlm.nih.gov/pubmed/26644131
http://dx.doi.org/10.1186/s12245-015-0096-x
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