D'Avolio Deborah A, Strumpf Neville E, Feldman James, Mitchell Patricia, Rebholz Casey M
Northeastern University, Boston, MA, USA.
Clin Nurs Res. 2013 Nov;22(4):416-31. doi: 10.1177/1054773813485597. Epub 2013 Apr 25.
This purpose of this mixed methods study was to understand access to primary care among older adults who present to an inner city emergency department (ED) for nonurgent care. Questionnaires (N = 62) included demographic, illness characteristics, and health care utilization. Qualitative interviews (N = 20) were conducted. Data was analyzed using descriptive statistics, and qualitative methodology. More than half of the participants were female (60%), African American (57%) and pain was the presenting symptoms among 48% of the participants. Nearly all participants reported barriers to primary care; difficulty with phone systems and staff, and lack of available appointments resulting in an ED visit. Older adults face barriers accessing primary care and as a result, can turn to the ED for their primary care needs. Interventions to improve access for vulnerable older adults might have benefits not only for patient outcomes but also for health policy issues related to cost effective care and overcrowded EDs.
这项混合方法研究的目的是了解那些前往市中心急诊科寻求非紧急护理的老年人获得初级保健服务的情况。问卷（n = 62）涵盖了人口统计学、疾病特征和医疗保健利用情况。进行了定性访谈（n = 20）。使用描述性统计和定性方法对数据进行了分析。超过一半的参与者为女性（60%），非裔美国人（57%），48%的参与者以疼痛为主要症状。几乎所有参与者都报告了获得初级保健服务的障碍；电话系统和工作人员方面的困难，以及缺乏可用预约导致前往急诊科就诊。老年人在获得初级保健服务方面面临障碍，因此，可能会因初级保健需求而求助于急诊科。改善弱势老年人获得医疗服务机会的干预措施不仅可能对患者预后有益，而且可能对与成本效益护理和急诊科过度拥挤相关的卫生政策问题有益。
