Gray Jodi, Partington Andrew, Karnon Jonathan
Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Bedford Park, Australia.
JMIR Hum Factors. 2021 Sep 8;8(3):e30878. doi: 10.2196/30878.
An increase in the number of people presenting to emergency departments (EDs) is contributing to ED overcrowding. In the early stages of the COVID-19 pandemic, there was a significant reduction in the number of ED presentations in Australia, creating an opportunity to learn from patients' experiences of alternative management options.
The aim of this study is to report on the use and experience of health services by Australian adults experiencing a health issue during the COVID-19 pandemic for which they would have presented at an ED prior to the pandemic.
An online survey was conducted in May 2020. Reported health issues were categorized using an existing classification system. Data collected included demographics, care pathways, levels of concern at times of health issue and survey completion, and patient-reported experiences with care.
A total of 1289 eligible respondents completed the survey. Almost 25% (309/1289) of respondents avoided an ED presentation, of which 58% (179/309) used an alternative form of health care and 42% (130/309) self-managed. Respondents making face-to-face or telehealth appointments with their general practitioner (GP) reported high levels of ED avoidance (135/286, 47%) and mostly positive experiences of care provided by GPs. A high proportion of those who self-managed reported high levels of concern at the time of completing the survey (42/130, 32%).
Telehealth consultations with GPs may be a more promotable alternative to the ED beyond the COVID-19 pandemic, providing easier access to a doctor with access to patients' medical histories than an appointment for a face-to-face consultation. GP telehealth consultations may also address barriers to accessing health care for those with potentially the greatest need. The reported use and positive experiences with GP telehealth appointments should inform further research on their appropriateness as an alternative to the ED.
前往急诊科（ED）就诊的人数增加导致了急诊科过度拥挤。在新冠疫情的早期阶段，澳大利亚急诊科的就诊人数大幅减少，这为了解患者对替代管理方案的体验创造了机会。
本研究旨在报告澳大利亚成年人在新冠疫情期间遇到健康问题时对医疗服务的使用情况和体验，这些问题在疫情之前他们会前往急诊科就诊。
2020年5月进行了一项在线调查。使用现有的分类系统对报告的健康问题进行分类。收集的数据包括人口统计学信息、护理途径、健康问题发生时和调查完成时的关注程度，以及患者报告的护理体验。
共有1289名符合条件的受访者完成了调查。近25%（309/1289）的受访者避免了前往急诊科就诊，其中58%（179/309）使用了其他形式的医疗保健，42%（130/309）进行了自我管理。与全科医生（GP）进行面对面或远程医疗预约的受访者报告称，避免前往急诊科就诊的比例很高（135/286，47%），并且对全科医生提供的护理体验大多为积极。自我管理的受访者中，很大一部分在完成调查时表示高度关注（42/130，32%）。
在新冠疫情之后，与全科医生进行远程医疗咨询可能是急诊科更值得推广的替代方案，与面对面咨询预约相比，它能让患者更轻松地联系到了解其病史的医生。全科医生远程医疗咨询还可能解决那些有最大需求的人在获取医疗保健方面的障碍。所报告的对全科医生远程医疗预约的使用情况和积极体验应为进一步研究其作为急诊科替代方案的适用性提供参考。
