移民患者前往急诊科的主观原因。
Subjective reasons why immigrant patients attend the emergency department.
作者信息
Mahmoud Ibrahim, Eley Rob, Hou Xiang-Yu
机构信息
Department of Emergency Medicine, Royal Brisbane & Women's Hospital - School of Medicine, The University of Queensland, and School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia.
School of Medicine and the Department of Emergency Medicine- Princess Alexandra Hospital, The University of Queensland, Brisbane, Australia.
出版信息
BMC Emerg Med. 2015 Mar 28;15:4. doi: 10.1186/s12873-015-0031-8.
BACKGROUND
Some patients visit a hospital's emergency department (ED) for reasons other than an urgent medical condition. There is evidence that this practice may differ among patients from different backgrounds. The objective of this study was to examine the reasons why patients from a non-English speaking background (NESB) and patients with an English speaking background but not born in Australia (ESB-NBA) visit the ED, as compared to patients from English-speaking backgrounds but born in Australia (ESB-BA).
METHODS
A cross-sectional survey was conducted at the ED of a tertiary hospital in metropolitan Brisbane, Queensland, Australia. Over a four-month period patients who were assigned an Australasian Triage Scale score of 3, 4 or 5 were surveyed. Pearson chi-square test and multivariate logistic regression analyses were performed to examine the differences between the ESB and NESB patients' reported reasons for attending the ED.
RESULTS
A total of 828 patients participated in this study. Compared to ESB-BA patients NESB patients were less likely to consider contacting a general practitioner (GP) before attending the ED (Odds Ratios (OR) 0.6 (95% Confidence Interval (CI) 0.4-0.8, p < .05) While ESB-NBA were more likely to consider contacting a GP 1.7 (1.1-2.5, p < .05). Both the NESB patients and the ESB-NBA patients were far more likely than ESB-BA patients to report that they had visited the ED either because they do not have a GP (OR 7.9, 95% CI 4.7-13.4, p < .001) and 2.2 (95% CI 1.1-4.4, p < .05) respectively and less likely to think that the ED could deal with their problem better than a GP (OR 0.5 (95% CI 0.3-0.8, p < .05) and 0.7 (0.3-0.9, p < .05) respectively. The NESB patients also thought it would take too long to make an appointment to consult a GP (OR 6.2, 95% CI 3.7-10.4, p < 0.001).
CONCLUSIONS
NESB patients were the least likely to consider contacting a GP before attending hospital EDs. Educational interventions may help direct NESB people to the appropriate health services and therefore reduce the burden on tertiary hospitals ED.
背景
一些患者前往医院急诊科（ED）并非出于紧急医疗状况。有证据表明，这种情况在不同背景的患者中可能存在差异。本研究的目的是探讨非英语背景（NESB）患者、英语背景但非澳大利亚出生（ESB-NBA）的患者与英语背景且澳大利亚出生（ESB-BA）的患者前往急诊科的原因。
方法
在澳大利亚昆士兰州布里斯班市一家三级医院的急诊科进行了一项横断面调查。在四个月的时间里，对分诊等级为3、4或5级的患者进行了调查。采用Pearson卡方检验和多因素逻辑回归分析来研究ESB患者和NESB患者前往急诊科的报告原因之间的差异。
结果
共有828名患者参与了本研究。与ESB-BA患者相比，NESB患者在前往急诊科之前联系全科医生（GP）的可能性较小（优势比（OR）为0.6（95%置信区间（CI）为0.4-0.8，p<0.05）），而ESB-NBA患者联系全科医生的可能性更大，为1.7（1.1-2.5，p<0.05）。NESB患者和ESB-NBA患者报告前往急诊科的原因远多于ESB-BA患者，分别是因为他们没有全科医生（OR为7.9，95%CI为4.7-13.4，p<0.001）和2.2（95%CI为1.1-4.4，p<0.05），并且认为急诊科比全科医生更能处理他们问题的可能性较小（OR分别为0.5（95%CI为0.3-0.8，p<0.05）和0.7（0.3-0.9，p<0.05））。NESB患者还认为预约看全科医生的时间太长（OR为6.2，95%CI为3.7-10.4，p<0.001）。
结论
NESB患者在前往医院急诊科之前联系全科医生的可能性最小。教育干预可能有助于引导NESB人群获得适当的医疗服务，从而减轻三级医院急诊科的负担。
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