Frick J, Möckel M, Schmiedhofer M, Searle J, Erdmann B, Erhart M, Slagman A
Arbeitsbereich Notfallmedizin/Rettungsstellen (CVK, CCM), Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Deutschland.
Notaufnahme Klinikum Wolfsburg, Sauerbruchstr. 7, 38440, Wolfsburg, Deutschland.
Med Klin Intensivmed Notfmed. 2019 Feb;114(1):38-44. doi: 10.1007/s00063-017-0345-2. Epub 2017 Sep 12.
For several years, Emergency Departments (ED) in Germany have observed increasing patient numbers, resulting in ED crowding. This leads to the question of whether patients with nonurgent conditions could also receive adequate treatment in primary care. Our objective was to develop a quantitative questionnaire to investigate in a larger patient group the reasons for this and to describe the implications for a patient survey in the ED.
The development of the questionnaire was based on a literature search and the results of the qualitative EPICS-2 study. Two pretest surveys were conducted in three EDs at the Charité - Universitätsmedizin Berlin. We included patients aged ≥ 18 years with outpatient treatment and the categories blue (nonurgent), green (standard), or yellow (urgent) according to the Manchester Triage System (MTS).
In total, 189 patients were recruited in two surveys (pretest 1: n = 89, pretest 2 n = 100). The final questionnaire includes 24 items, which were evaluated and adapted during both pretests. The items evaluate basic clinical characteristics, reasons for choosing the ED, prior contacts in primary care, utilization of primary care after-hours services as well as sociodemographic characteristics. Data from the hospital information system were used to link the survey data with clinical characteristics.
The questionnaire is based on reasons for ED utilization. We recommend the written, self-applied questionnaire for patient surveys with plausibility checks conducted by staff. It is necessary to consider the heterogenic study surroundings in the ED, which requires a lot of flexibility during data collection.
多年来,德国急诊科观察到患者数量不断增加,导致急诊科拥挤不堪。这就引发了一个问题,即非紧急情况的患者是否也能在初级保健中获得充分治疗。我们的目标是制定一份定量问卷,以便在更大的患者群体中调查其原因,并描述对急诊科患者调查的影响。
问卷的制定基于文献检索和定性EPICS - 2研究的结果。在柏林夏里特大学医学中心的三个急诊科进行了两次预测试调查。我们纳入了年龄≥18岁、接受门诊治疗且根据曼彻斯特分诊系统(MTS)分为蓝色(非紧急)、绿色(标准)或黄色(紧急)类别的患者。
两次调查共招募了189名患者(预测试1:n = 89,预测试2:n = 100)。最终问卷包括24个项目,在两次预测试中均进行了评估和调整。这些项目评估基本临床特征、选择急诊科的原因、在初级保健中的先前就诊情况、初级保健非工作时间服务的利用情况以及社会人口学特征。利用医院信息系统的数据将调查数据与临床特征相联系。
该问卷基于急诊科利用的原因。我们建议使用书面的、患者自行填写的问卷进行患者调查,并由工作人员进行合理性检查。有必要考虑急诊科异质性的研究环境,这在数据收集过程中需要很大的灵活性。