Miyazawa Asako, Maeno Takami, Shaku Fumio, Tsutsumi Madoka, Kurihara Hiroshi, Takayashiki Ayumi, Kohno Mototsugu, Suzuki Masatsune, Maeno Tetsuhiro
Department of Primary care and Medical Education Doctoral Program in Clinical Sciences Graduate School of Comprehensive Human Sciences University of Tsukuba Tsukuba Ibaraki Japan.
Department of Primary care and Medical Education Faculty of Medicine University of Tsukuba Tsukuba Ibaraki Japan.
J Gen Fam Med. 2019 Apr 29;20(4):146-153. doi: 10.1002/jgf2.249. eCollection 2019 Jul.
The purpose of this study was to investigate the primary factors associated with inappropriate out-of-hours emergency department (ED) use by patients with nonurgent conditions.
We compared patients with nonurgent conditions who made inappropriate, out-of-hours ED visits to patients who visited an acute care hospital during daytime consultation hours between May 30 and October 16, 2014, in terms of patient characteristics and reasons for consultation. Our goal was to identify factors associated with inappropriate ED use, defined as an out-of-hours, nonurgent, and unnecessary visits.
We analyzed data from 84 patients who made inappropriate use of out-of-hours emergency care and 147 patients who sought care during regular consultation hours. In the inappropriate use group, "desire to be cured quickly" was the most common reason. Acute upper respiratory infection, acute gastroenteritis, and primary headache comprised 51.1% of diagnoses in the inappropriate use group. One factor associated with inappropriate use was two or more previous out-of-hours ED visits (odds ratio (OR) 3.19; 95% confidence interval (CI) 1.22-8.31) (reference: 0 visits).
Patients with two or more previous out-of-hours ED visits were more than three times as likely to inappropriately use the ED compared to patients who had not visited the ED at all in the past 3 years.
本研究旨在调查非紧急情况患者非工作时间不适当使用急诊科的主要相关因素。
我们比较了2014年5月30日至10月16日期间，非紧急情况患者在非工作时间不适当使用急诊科与在日间门诊时间前往急症医院就诊的患者的特征及就诊原因。我们的目标是确定与不适当使用急诊科相关的因素，不适当使用定义为非工作时间、非紧急且不必要的就诊。
我们分析了84例不适当使用非工作时间紧急护理患者及147例在正常门诊时间就诊患者的数据。在不适当使用组中，“渴望快速治愈”是最常见的原因。急性上呼吸道感染、急性肠胃炎和原发性头痛占不适当使用组诊断的51.1%。与不适当使用相关的一个因素是之前有过两次或更多次非工作时间急诊科就诊（比值比（OR）3.19；95%置信区间（CI）1.22 - 8.31）（参照：0次就诊）。
与过去3年从未去过急诊科的患者相比，之前有过两次或更多次非工作时间急诊科就诊的患者不适当使用急诊科的可能性高出三倍多。
