University of California, Davis Medical Center, Department of Emergency Medicine, Sacramento, California.
West J Emerg Med. 2019 Jul;20(4):672-680. doi: 10.5811/westjem.2019.5.42762. Epub 2019 Jul 2.
Patients discharged from the emergency department (ED) may encounter difficulty finding transportation home, increasing length of stay and ED crowding. We sought to determine the preferences of patients discharged from the ED with regard to their transportation home, and their awareness and past use of ridesharing services such as Lyft and Uber.
We performed a prospective, survey-based study during a five-month period at a university-associated ED and Level I trauma center serving an urban area. Subjects were adult patients who were about to be discharged from the ED. We excluded patients requiring ambulance transport home.
Of 500 surveys distributed, 480 (96%) were completed. Average age was 47 ± 19 years, and 61% were female. There were 33,871 ED visits during the study period, and 67% were discharged home. The highest number of subjects arrived by ambulance (27%) followed by being dropped off (25%). Of the 408 (85%) subjects aware of ridesharing services, only eight (2%) came to the ED by this manner; however, 22 (5%) planned to use these services post-discharge. The survey also indicated that 377 (79%) owned smartphones, and 220 (46%) used ridesharing services. The most common plan to get home was with family/friend (35%), which was also the most preferred (29%). Regarding awareness and past use of ridesharing services, we were unable to detect any gender and/or racial differences from univariate analysis. However, we did detect age, education and income differences regarding awareness, but only age and education differences for past use. Logistic regression showed awareness and past use decreased with increasing patient age, but correlated positively with increasing education and income. Half the subjects felt their medical insurance should pay for their transportation, whereas roughly one-third felt ED staff should pay for it.
Patients most commonly prefer to be driven home by a family member or friend after discharge from the ED. There is awareness of ridesharing services, but only 5% of patients planned to use these services post-discharge from the ED. Patients who are older, have limited income, and are less educated are less likely to be aware of or have previously used ridesharing services. ED staff may assist these patients by hailing ridesharing services for them at time of discharge.
从急诊科(ED)出院的患者在回家时可能会遇到困难,这会延长他们的住院时间并导致 ED 拥挤。我们旨在确定从 ED 出院的患者对其回家交通方式的偏好,以及他们对 Lyft 和 Uber 等拼车服务的了解和过去的使用情况。
我们在一所大学附属的 ED 和一级创伤中心进行了一项为期五个月的前瞻性、基于调查的研究,该中心服务于一个城市地区。研究对象为即将从 ED 出院的成年患者。我们排除了需要救护车送回家的患者。
在分发的 500 份调查中,有 480 份(96%)完成了调查。平均年龄为 47 ± 19 岁,61%为女性。在研究期间,有 33871 人次到 ED 就诊,其中 67%出院回家。到达 ED 的患者中,乘坐救护车的人数最多(27%),其次是自行驾车(25%)。在 408 名(85%)知晓拼车服务的患者中,仅有 8 名(2%)以这种方式到达 ED;然而,有 22 名(5%)计划在出院后使用这些服务。调查还表明,377 名(79%)患者拥有智能手机,220 名(46%)使用过拼车服务。最常见的回家方式是与家人/朋友一起(35%),这也是最受欢迎的方式(29%)。关于对拼车服务的了解和过去的使用情况,我们无法从单因素分析中检测到任何性别和/或种族差异。然而,我们确实发现了在知晓、过去使用拼车服务方面存在年龄、教育和收入差异,但仅在过去使用方面存在年龄和教育差异。Logistic 回归显示,随着患者年龄的增加,知晓和过去使用拼车服务的比例会降低,但与教育和收入的增加呈正相关。有一半的患者认为他们的医疗保险应该支付他们的交通费,而大约三分之一的患者认为 ED 工作人员应该支付这笔费用。
从 ED 出院后,患者最常选择由家庭成员或朋友开车送回家。患者对拼车服务有一定的了解,但只有 5%的患者计划在 ED 出院后使用这些服务。年龄较大、收入较低、教育程度较低的患者不太可能了解或以前使用过拼车服务。ED 工作人员可以在患者出院时帮助他们叫拼车服务。