新加坡外籍劳工的就医行为：来自急诊就诊的观察。

Health-seeking behaviour of foreign workers in Singapore: Insights from emergency department visits.

机构信息

Department of Emergency Medicine, Singapore General Hospital, Singapore.

出版信息

Ann Acad Med Singap. 2021 Apr;50(4):315-324. doi: 10.47102/annals-acadmedsg.2020484.

DOI:10.47102/annals-acadmedsg.2020484

PMID:33990819

Abstract

INTRODUCTION

Foreign workers (FWs) on work permit face unique health challenges and potential barriers to healthcare. We aimed to examine the epidemiology, attendance patterns, disposition, and adherence to follow-up, by FWs on work permit to two emergency departments (EDs) in Singapore.

METHODS

In this retrospective observational study, we included consecutive FWs on work permit who registered at the EDs of two public restructured hospitals from 1 May 2016 to 31 October 2016. Data obtained from electronic medical records included patient demographics, triage acuity, disposition, ED diagnoses and bill information.

RESULTS

There were 6,429 individual FWs on work permit who contributed to 7,157 ED visits over the 6-month study period, with male predominance (72.7%, 4672/6429), and median age of 31 (interquartile range 26 to 38) years. A high proportion of these FWs were triaged to low-acuity status compared to the general ED population (66.9% versus 45.9%, <0.001). Trauma-related injuries contributed to 34.4% of their visits, and were more likely to result in admission compared to non-trauma-related conditions (18.7% vs 15.2%, <0.001). FWs engaged in shipyard, construction and process industries were more likely to be discharged "against medical advice" (14.8% vs 3.2%, <0.001), and default their specialist outpatient follow-up (50.1% vs 34.2%, <0.001) for non-trauma-related conditions compared to trauma-related injuries.

CONCLUSION

In Singapore, the EDs of public restructured hospitals provide healthcare safety nets to FWs on work permit. These workers made more low-acuity visits compared to the general population during the study period and may face potential barriers to admission and follow-up.

摘要

简介

工作许可外国工人（FWs）面临独特的健康挑战和医疗保健障碍。我们旨在检查流行病学、出勤率、处置和随访情况，在新加坡的两家急诊部（EDs）接受工作许可的 FW。

方法

在这项回顾性观察研究中，我们包括了 2016 年 5 月 1 日至 10 月 31 日期间在两家公立重组医院的 ED 登记的连续工作许可 FW。从电子病历中获得的数据包括患者人口统计学、分诊 acuity、处置、ED 诊断和账单信息。

结果

在 6 个月的研究期间，共有 6429 名工作许可的外国工人个人为 7157 次 ED 就诊做出了贡献，其中男性占多数（72.7%，4672/6429），中位年龄为 31 岁（四分位间距 26 至 38 岁）。与一般 ED 人群相比，这些 FW 的分诊到低 acuity 状态的比例较高（66.9%比 45.9%，<0.001）。与非创伤相关疾病相比，创伤相关损伤导致了他们就诊的 34.4%，更有可能导致入院（18.7%比 15.2%，<0.001）。从事船厂、建筑和工艺行业的 FW 更有可能被“违反医嘱”出院（14.8%比 3.2%，<0.001），并且在非创伤相关疾病方面更有可能不遵守专科门诊随访（50.1%比 34.2%，<0.001）。