Rieffe C, Oosterveld P, Wijkel D, Wiefferink C
Department of Developmental Psychology, Free University, Amsterdam, The Netherlands.
Accid Emerg Nurs. 1999 Oct;7(4):217-25. doi: 10.1016/s0965-2302(99)80054-x.
Knowledge about what motivates patients to visit the emergency department (ED) of a hospital for minor complaints, instead of visiting their general practitioner (GP), can help to reduce unnecessary utilization of expensive services. This paper reports on a study designed to investigate the reasons why patients visit the ED and to determine the influence of patient characteristics on specific motives. A multidimensional measurement instrument was designed to identify the motives of patients who bypass their GP and visit the ED. The instrument assessed 21 motives, all measured by means of three questions in Likert format. During a period of 1 week, all patients who visited the ED of two hospitals in Amsterdam were asked to complete a questionnaire when they were 'self-referred' with minor complaints. A total of 403 questionnaires were analysed, and the results show that motives relating to the GP play a minor role in the decision of patients to visit the ED. Profiles of two major patient groups could be identified. One group comprised patients with a high socio-economic status living in suburbs, whose motives for visiting the ED are mainly of a financial nature. Patients in the second group mainly lived in the inner-city, and preferred the expertise and facilities provided by the ED.
了解促使患者因轻微不适前往医院急诊科而非看全科医生的原因，有助于减少对昂贵医疗服务的不必要使用。本文报告了一项研究，旨在调查患者前往急诊科的原因，并确定患者特征对特定动机的影响。设计了一种多维测量工具，以识别绕过全科医生而前往急诊科的患者的动机。该工具评估了21种动机，均通过李克特量表形式的三个问题进行测量。在为期1周的时间里，所有因轻微不适“自行前往”阿姆斯特丹两家医院急诊科的患者均被要求填写一份问卷。共分析了403份问卷，结果表明，与全科医生相关的动机在患者前往急诊科的决定中作用较小。可以识别出两个主要患者群体的特征。一组是居住在郊区、社会经济地位较高的患者，他们前往急诊科的动机主要是出于经济方面的考虑。第二组患者主要居住在市中心，他们更喜欢急诊科提供的专业知识和设施。
