Emergency Hospital Services, Sainte Anne Army Training Hospital, Toulon, France.
University Committee of Resources for Research in Health (CURRS), University of Reims Champagne-Ardenne, Reims, France.
Front Public Health. 2023 Jul 7;11:1189939. doi: 10.3389/fpubh.2023.1189939. eCollection 2023.
The use of emergency hospital service has become increasingly frequent with a rise of approximately 3.6%. in annual emergency department visits. The objective of this study was to describe the reasons for reconsultations to emergency departments and to identify the risk and protective factors of reconsultations linked to healthcare-associated adverse events.
A retrospective, descriptive, multicenter study was performed in the emergency department of Troyes Hospital and the Sainte Anne Army Training Hospital in Toulon, France from January 1 to December 31, 2019. Patients over 18 years of age who returned to the emergency department for a reconsultation within 7 days were included. Healthcare-associated adverse events in the univariate analysis ( < 0.10) were introduced into a multivariate logistic regression model. Model performance was examined using the Hosmer-Lemeshow test and calculated with c-statistic.
Weekend visits and performing radiology examinations were risk factors linked to healthcare associated adverse events. Biological examinations and the opinion of a specialist were protective factors.
Numerous studies have reported that a first consultation occurring on a weekend is a reconsultation risk factor for healthcare-associated adverse events, however, performing radiology examinations were subjected to confusion bias. Patients having radiology examinations due to trauma-related pathologies were more apt for a reconsultation.
Our study supports the need for better emergency departments access to biological examinations and specialist second medical opinions. An appropriate patient to doctor ratio in hospital emergency departments may be necessary at all times.
随着急诊就诊量每年约增加 3.6%,急诊服务的使用频率越来越高。本研究旨在描述急诊复诊的原因,并确定与医疗相关不良事件相关的复诊风险和保护因素。
本研究为 2019 年 1 月 1 日至 12 月 31 日在法国特鲁瓦医院和土伦 Sainte Anne 陆军训练医院的急诊科进行的回顾性、描述性、多中心研究。研究纳入在 7 天内因再次就诊而返回急诊的 18 岁以上患者。在单因素分析中(<0.10),将与医疗相关的不良事件纳入多因素逻辑回归模型。采用 Hosmer-Lemeshow 检验和计算 c 统计量评估模型性能。
周末就诊和进行影像学检查是与医疗相关不良事件相关的危险因素,而进行生物检查和专家意见则是保护因素。
许多研究报告称,周末就诊是与医疗相关不良事件相关的复诊危险因素,但进行影像学检查存在混淆偏差。由于与创伤相关的病理而进行影像学检查的患者更有可能再次就诊。
我们的研究支持急诊部门更好地获得生物检查和专家二次医疗意见的需求。在任何时候,医院急诊部门都需要保持适当的医患比例。