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儿科急诊非紧急情况就诊:家庭医学能否预防这种情况?

Paediatric emergency department visits for non-urgent conditions: Can family medicine prevent this?

机构信息

Department of Family Medicine, Gaziantep University Faculty of Medicine, Gaziantep, Turkey.

Department of Pediatrics, Gaziantep University Faculty of Medicine, Gaziantep, Turkey.

出版信息

Eur J Gen Pract. 2020 Dec;26(1):134-139. doi: 10.1080/13814788.2020.1825676.

Abstract

BACKGROUND

In Turkey, family physicians serve only during office hours, while emergency services have 7/24 free access. Non-urgent patients commonly use Paediatric Emergency departments (PEDs). In Turkey, there is little evidence as to why emergency services are used instead of family medicine for non-urgent paediatric healthcare.

OBJECTIVES

To evaluate the causes and factors affecting non-urgent PED visits. To determine the reason for non-use of family medicine for non-urgent paediatric healthcare.

METHODS

We conducted a cross-sectional study at Gaziantep University PED between April and May 2019. We administered a questionnaire to the parents of children (from one month to 16 years) triaged to non-urgent (level-5) using a 5-level triage system.

RESULTS

A total of 457 parents were surveyed. The average patient age was 6.5 ± 4.7 years and 24.5% had a chronic disease. One-third of the parents (33.7%) considered their children's condition 'very urgent'. The most important reason for preferring PED (42.5%) instead of family physician or alternative health facilities was the thought that the condition of children would worsen. Two hundred fifty-three (55.4%) of the patients presented outside working hours. Although 58.9% of parents were satisfied with the family physician, most (67.8%) stated that they preferred other specialists rather than family physicians when the child had health problems. Fathers who were primary school graduates were more likely to prefer other specialists than family physicians.

CONCLUSION

Parents' perception of urgency and the thought that their child's condition will worsen are the main reasons for non-urgent using PED.

摘要

背景

在土耳其,家庭医生仅在办公时间提供服务,而急诊服务则 24 小时免费开放。非紧急患者通常会选择儿科急诊部门(PED)。在土耳其,关于为什么非紧急儿科保健会选择急诊服务而不是家庭医学,几乎没有证据。

目的

评估非紧急 PED 就诊的原因和影响因素。确定非紧急儿科保健不使用家庭医学的原因。

方法

我们在 2019 年 4 月至 5 月期间在加济安泰普大学 PED 进行了一项横断面研究。我们使用 5 级分诊系统对分诊为非紧急(5 级)的儿童(1 个月至 16 岁)的父母进行问卷调查。

结果

共调查了 457 位家长。患儿平均年龄为 6.5±4.7 岁,24.5%有慢性病。三分之一的家长(33.7%)认为孩子的病情“非常紧急”。选择 PED(42.5%)而不是家庭医生或其他医疗设施的最重要原因是认为孩子的病情会恶化。253 名(55.4%)患儿在工作时间之外就诊。尽管 58.9%的家长对家庭医生表示满意,但大多数家长(67.8%)表示当孩子出现健康问题时,他们更愿意选择其他专科医生而不是家庭医生。父亲是小学毕业生的,更倾向于选择其他专科医生而不是家庭医生。

结论

父母对紧急程度的认知和认为孩子病情会恶化是导致非紧急使用 PED 的主要原因。

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