Emergency Department, University Hospital of Bichat, 75018 Paris, France.
Study Group for Efficiency and Quality of Emergency Departments and Non-scheduled Activities Departments, 75018 Paris, France.
Int J Environ Res Public Health. 2019 Nov 12;16(22):4431. doi: 10.3390/ijerph16224431.
Consultations that do not require an emergency department (ED) level of care have increased. We explored attitudes of non-urgent patients in two academic hospitals in France with a similar fast track organization. One of them is a Parisian hospital with 90,000 patients/year who are admitted to the ED, while the other admits 40,000 patients/year in a smaller city. During one month in 2018, the triage nurse handed out a survey to patients coming for non-urgent consultations. It was given back to the fast track physician at the end of the visit; 598 patients agreed to answer. They were mostly young males with adequate social coverage, consulting for osteo-articular pathologies, without any significant difference between the two sites ( = 0.32). They were equally satisfied with the care they received ( = 0.38). Satisfaction was inversely correlated to waiting time ( < 0.0001). Convenience, accessibility of emergency facilities, and geographic proximity were motivation factors. These results suggest that primary care providers who can access testing facilities in accordance with patient needs might be a solution to help reduce overcrowding in EDs.
不需要急诊科(ED)级别的护理的就诊量有所增加。我们在法国的两家学术医院研究了非紧急患者的态度,这两家医院都有类似的快速通道组织。其中一家是巴黎的一家医院,每年有 90000 名患者就诊于急诊科,而另一家则在一个较小的城市每年收治 40000 名患者。在 2018 年的一个月里,分诊护士向非紧急就诊的患者发放了一份调查问卷。患者在就诊结束时将问卷交还给快速通道医生;共有 598 名患者同意回答。他们大多是年轻男性,社会福利充足,咨询的是骨关节炎疾病,两个地点之间没有明显差异(= 0.32)。他们对所接受的护理同样满意(= 0.38)。满意度与等待时间呈负相关(< 0.0001)。方便、紧急设施的可及性和地理位置的接近性是促成因素。这些结果表明,能够根据患者的需求提供检查设施的初级保健提供者可能是解决急诊科过度拥挤问题的一种方法。