Krieg Cynthia, Hudon Catherine, Chouinard Maud-Christine, Dufour Isabelle
Faculty of Medicine and Health Sciences, Université de Sherbrooke, 1500 James-Quintin, app. 3001, Sherbrooke, Québec, J1E 0E5, Canada.
Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Sherbrooke, Québec, Canada.
BMC Health Serv Res. 2016 Oct 20;16(1):594. doi: 10.1186/s12913-016-1852-1.
A small proportion of patients use an excessively large amount of emergency care resources which often results in emergency department (ED) overcrowding, decreased quality of care and efficiency. There is a need to better identify these patients in order to target those who will benefit most from interventions adapted to their specific needs. We aimed to identify the predictive factors of short-term frequent use of ED (over a 1-year period) and chronic frequent use of ED (over a multiple-year period) and to highlight recurring characteristics in patients.
A scoping review was performed of all relevant articles found in Medline published between 1979 and 2015 (Ovid). This scoping review included a total of 20 studies, of these, 16 articles focussed on frequent ED users and four others on chronic frequent ED users.
A majority of articles confirm that patients who frequently visit the ED are persons of low socioeconomic status. Both frequent and chronic frequent ED users show high levels of health care use (other than the ED) and suffer from multiple physical and mental conditions.
This research highlights which individual factors predict frequent emergency department use. Further research is needed to better characterize and understand chronic frequent users as well as the health issues and unmet medical needs that lead to chronic frequent ED use.
一小部分患者使用了过多的急诊护理资源,这常常导致急诊科过度拥挤、护理质量下降和效率降低。有必要更好地识别这些患者,以便针对那些将从适应其特定需求的干预措施中获益最大的患者。我们旨在确定短期频繁使用急诊科(在1年期间)和长期频繁使用急诊科(在多年期间)的预测因素,并突出患者的反复出现的特征。
对1979年至2015年(Ovid)在Medline上发表的所有相关文章进行了范围综述。该范围综述共纳入20项研究,其中16篇文章关注频繁使用急诊科的患者,另外4篇关注长期频繁使用急诊科的患者。
大多数文章证实,频繁就诊急诊科的患者是社会经济地位较低的人群。频繁和长期频繁使用急诊科的患者都有较高的医疗保健使用率(除急诊科外),并患有多种身心疾病。
本研究突出了哪些个体因素可预测频繁使用急诊科。需要进一步研究以更好地描述和理解长期频繁使用者以及导致长期频繁使用急诊科的健康问题和未满足的医疗需求。