*Inflammatory Bowel Disease Clinical and Research Centre, University of Manitoba, Winnipeg, Manitoba, Canada; and Departments of †Psychology, ‡Clinical Health Psychology, and §Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
Inflamm Bowel Dis. 2017 Sep;23(9):1461-1469. doi: 10.1097/MIB.0000000000001215.
We aimed to explore factors associated with health service utilization and preference for services, including alternatives to attending the emergency department (ED) when experiencing mild to moderate or severe symptoms.
A total of 1143 persons (46% response rate) aged 18 to 65 years in the population-based University of Manitoba IBD Research Registry participated in the survey.
Although 61% had a gastroenterologist, when experiencing active symptoms, only 29% felt they could call their gastroenterologist for an urgent appointment, and 42% could call their gastroenterologist for telephone advice. Nine percent of the respondents visited the ED in the previous year. If having severe symptoms, 48% said that they would attend the ED. Visits to the ED were related to higher bowel symptom severity and high health anxiety. When experiencing severe symptoms, women, persons with Crohn's disease and those with high health anxiety, indicated that they would be more likely to use the ED. Considering services which could be available in the future respondents indicated that if acutely symptomatic they would be very likely or likely to use the following services: phone contact with inflammatory bowel disease nurse (77%), phone contact with a gastroenterologist (75%), and going to a walk-in gastroenterology clinic (71%).
Persons with inflammatory bowel disease are receptive to options other than the ED when experiencing inflammatory bowel disease symptoms; however, attending the ED remains a prominent choice. Improved access to specialized care may improve timeliness of care and reduce ED attendance. Future research should include the impact of health anxiety on health care utilization.
本研究旨在探讨与卫生服务利用和服务偏好相关的因素，包括在出现轻度至中度或重度症状时选择替代急诊就诊的方案。
共招募了 1143 名年龄在 18 至 65 岁的曼尼托巴大学炎症性肠病研究注册库的人群（46%的响应率）参与调查。
尽管 61%的参与者有胃肠病专家，但当出现活跃症状时，只有 29%的人认为他们可以打电话给胃肠病专家预约紧急就诊，42%的人可以打电话咨询胃肠病专家。9%的受访者在过去一年中去过急诊。如果出现严重症状，48%的人表示会去急诊。去急诊与更高的肠道症状严重程度和更高的健康焦虑有关。当出现严重症状时，女性、克罗恩病患者和健康焦虑程度较高的患者更有可能使用急诊。考虑到未来可能提供的服务，受访者表示如果出现急性症状，他们非常可能或可能会使用以下服务：与炎症性肠病护士电话联系（77%）、与胃肠病专家电话联系（75%）、以及去免预约的胃肠病诊所就诊（71%）。
炎症性肠病患者在出现炎症性肠病症状时愿意选择除急诊以外的其他方案；然而，去急诊仍然是一个突出的选择。改善对专科护理的获取可能会提高护理及时性并减少急诊就诊。未来的研究应包括健康焦虑对医疗保健利用的影响。
