Reinhold A K, Greiner F, Schirrmeister W, Walcher F, Erdmann B
Medizinische Fakultät, Universitätsklinik für Unfallchirurgie, Otto-von-Guericke-Universität Magdeburg, Magdeburg, Deutschland.
Zentrale Notfallaufnahme, Klinikum Wolfsburg, Sauerbruchstraße 7, 38440, Wolfsburg, Deutschland.
Med Klin Intensivmed Notfmed. 2021 Sep;116(6):511-521. doi: 10.1007/s00063-020-00681-4. Epub 2020 Apr 14.
Besides increasing numbers of cases in German emergency departments (ED), the spectrum of attending patients is also changing. Patients with acute illnesses tend to prefer EDs to ambulatory care as primary contact point. This study examines the motives for use and use behavior of low-urgent ED-patients.
Anonymous patient survey in the ED of Wolfsburg Hospital between 12/2015 and 03/2016 with descriptive analysis. All patients with low urgency (Manchester-Triage-System (MTS), levels blue and green) were eligible.
81.5% of respondents (729 evaluable out of 7000 questionnaires distributed) attended the ED between 8:00 a. m. and 5:00 p. m., 70.1 % of them were walk-in patients. The motive most frequently cited was that they would receive better care in the ED (48.3 %). Contrary to acuity assessment, 67.8 % of respondents considered themselves a medium to life-threatening emergency. As alternative option, 49.2 % would choose a nearby clinic in the region for their complaints.
Self-assessed urgency differs with acuity assessment according to MTS. Patients who fear an acute threat to their health do not use services provided in the ambulatory sector such as the emergency practice of the Association of Statutory Health Insurance Physicians in the immediate proximity sufficiently. Previous approaches for patient navigation do not seem to be successful in this setting. Strengthening of EDs as a single 24/7 access point for emergency care with simultaneous abolition of parallel care structures should be discussed.
除了德国急诊科就诊病例数量不断增加外，就诊患者的构成也在发生变化。患有急性疾病的患者倾向于选择急诊科而非门诊作为首要就诊地点。本研究调查了低紧急程度急诊科患者的就诊动机和就诊行为。
2015年12月至2016年3月期间，在沃尔夫斯堡医院急诊科进行了匿名患者调查，并进行描述性分析。所有低紧急程度（曼彻斯特分诊系统（MTS）蓝色和绿色级别）的患者均符合条件。
81.5%的受访者（在分发的7000份问卷中，729份可评估）在上午8:00至下午5:00之间前往急诊科就诊，其中70.1%为自行前来就诊的患者。最常提及的动机是他们认为在急诊科能得到更好的治疗（48.3%）。与紧急程度评估相反，67.8%的受访者认为自己处于中度至危及生命的紧急状态。作为替代选择，49.2%的人会因自身症状选择附近地区的诊所。
自我评估的紧急程度与MTS的紧急程度评估结果不同。担心自身健康受到急性威胁的患者没有充分利用门诊部门提供的服务，如紧邻的法定健康保险医师协会的急诊诊所。在这种情况下，以往的患者引导方法似乎并不成功。应讨论加强急诊科作为唯一的全天候紧急护理接入点，同时取消并行护理结构的问题。
