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我们为何等待?患者对因非紧急诉求而使用急诊科服务的看法。

Why are we waiting? Patients' perspectives for accessing emergency department services with non-urgent complaints.

作者信息

Unwin Maria, Kinsman Leigh, Rigby Scott

机构信息

Faculty of Health Science, University of Tasmania, Australia; Tasmanian Health Service, Australia.

Faculty of Health Science, University of Tasmania, Australia; Tasmanian Health Service, Australia.

出版信息

Int Emerg Nurs. 2016 Nov;29:3-8. doi: 10.1016/j.ienj.2016.09.003. Epub 2016 Oct 21.

Abstract

[Background] Emergency departments world-wide report service demands which exceed resource availability. Themes such as crowding, non-urgent presentations, ambulance diversion and access block have been linked to complications in care, poorer patient outcomes, increased morbidity and staff burnout. People attending the emergency department with problems perceived as non-urgent are frequently attributed blame for increased service demand, yet little is known from the patients' perspective. [Method] This project utilised a descriptive cross-sectional waiting room survey of non-urgent patients to identify factors contributing to their decision making process to access ED services at a regional hospital in Tasmania, Australia. Data were analysed using a statistical software package and comparison made between the sample and population groups to determine broad representation. [Results] Patients' decision making processes were found to be influenced by convenience, perceived need and referral by a health care provider. Cost did not present as a significant factor. A high incidence of patients under 25years of age were identified and musculoskeletal complaints were the most common complaint across all age groups. [Conclusion] Further consideration is required to determine how to best meet service demand to facilitate the provision of the right service at the right time to the right patient.

摘要

[背景] 全球范围内的急诊科报告称,服务需求超过了资源可及性。诸如拥挤、非紧急就诊、救护车分流和通道堵塞等问题已被认为与护理并发症、患者预后较差、发病率增加以及工作人员倦怠有关。因被认为是非紧急问题而前往急诊科就诊的患者,常被指责导致服务需求增加,但从患者角度了解到的情况却很少。[方法] 本项目对非紧急患者进行了一项描述性横断面候诊室调查,以确定在澳大利亚塔斯马尼亚州一家地区医院,促使他们决定前往急诊科就诊的因素。使用统计软件包对数据进行分析,并对样本组和总体组进行比较,以确定是否具有广泛代表性。[结果] 发现患者的决策过程受便利性、感知到的需求以及医疗服务提供者的转诊影响。费用并非一个重要因素。确定了25岁以下患者的高发病率,肌肉骨骼疾病是所有年龄组中最常见的病症。[结论] 需要进一步考虑如何最好地满足服务需求,以便在正确的时间为正确的患者提供正确的服务。

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