Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
BMJ Open. 2019 Oct 9;9(10):e030927. doi: 10.1136/bmjopen-2019-030927.
To determine the percentage of non-urgent (NU) visits in an Iranian emergency department (ED), to explore why patients with NU conditions refer to EDs and also to assess the association between patients' characteristics and their visits.
A cross sectional study based on face to face survey.
A territorial, teaching and military hospital in Tehran province, Iran.
All patients who visited the ED during the 2-week period were recruited. Data were collected using a validated questionnaire.
Of 1884 patients who visited the ED, 1217 (64.6%) patients were triaged as NU while 667 (35.4%) were urgent and semiurgent visits cases. The most important reasons for NU visits were seeking prompt (36.6%) and less costly care (35.9%). We found that NU visits have increased with younger patients, during weekends and night shifts, and with patients suffering from recurrent symptoms lasting in 1 week or less.
EDs are a common source of care for NU problems in Iran. The most invaluable solution is building up special clinics for providing healthcare services to NU patients during the weekends and, in the busy and night shifts. Receiving higher fees from NU patients could also be adopted with caution. Promoting awareness and knowledge of both healthcare providers and patients about the main role of EDs will contribute in improving their performance. As a long-term solution, adopting the family physician programme and ameliorating the referral system are recommended.
确定伊朗急诊科(ED)中非紧急(NU)就诊的比例,探讨为什么有 NU 就诊条件的患者会选择 ED,并评估患者特征与其就诊之间的关联。
基于面对面调查的横断面研究。
伊朗德黑兰省的一家地区性、教学和军事医院。
在为期 2 周的时间内,招募了所有访问 ED 的患者。使用经过验证的问卷收集数据。
在 1884 名访问 ED 的患者中,1217 名(64.6%)患者被分诊为 NU,而 667 名(35.4%)为紧急和半紧急就诊。NU 就诊的最重要原因是寻求快速(36.6%)和成本较低的护理(35.9%)。我们发现,NU 就诊随着年轻患者、周末和夜班而增加,并且与患有持续 1 周或更短时间的复发性症状的患者有关。
ED 是伊朗 NU 问题的常见医疗服务来源。最有价值的解决方案是在周末为 NU 患者建立专门的诊所,提供医疗服务,并在繁忙和夜班期间,为 NU 患者收取更高的费用。提高医护人员和患者对 ED 主要作用的认识和了解,将有助于提高其绩效。作为长期解决方案,建议采用家庭医生计划和改善转诊系统。