Nonurgent patients in the emergency department? A French formula to prevent misuse

<p>Abstract</p> <p>Background</p> <p>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.</p> <p>Methods</p> <p>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.</p> <p>Results</p> <p>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.</p> <p>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%).</p> <p>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).</p> <p>Conclusions</p> <p>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.</p

Rapports et délibérations / Conseil général des Côtes-d'Armor

18861886-1886.Appartient à l’ensemble documentaire : Bretagn

Bulletins et mémoires.

At head of title: Société d'émulation des Côtes-du-Nord.Pubication suspended 1914-19.Vols. for 1904-68 include only the Mémoires.Vols. for 1861-65 issued in individual parts (Bulletin, Comptes-rendus, or Mémoires) without a common title.Vols. for 1861-72 carry various numberings but constitute v. 1-10.Mode of access: Internet

Rapports et délibérations / Conseil général des Côtes-d'Armor

19391939-1939.Appartient à l’ensemble documentaire : Bretagn

Société d'émulation des Côtes-du-Nord

19381938 (T70).Appartient à l’ensemble documentaire : Bretagn

Bulletins et mémoires / Société d'émulation des Côtes-du-Nord

19101910 (T48).Appartient à l’ensemble documentaire : Bretagn

Bulletins et mémoires / Société d'émulation des Côtes-du-Nord

19051905 (T43).Appartient à l’ensemble documentaire : Bretagn