太平洋地区患者因非紧急情况前往 Counties Manukau 急诊部的原因。

Pacific patients' reasons for attending the emergency department of Counties Manukau for non-urgent conditions.

机构信息

Public Health Registrar, School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland.

Senior Lecturer, Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland.

出版信息

N Z Med J. 2023 Jun 16;136(1577):22-34. doi: 10.26635/6965.6066.

DOI:10.26635/6965.6066

PMID:37778317

Abstract

AIM

To determine Pacific patients' reasons for Emergency Department (ED) use for non-urgent conditions by Pacific people at Counties Manukau Health.

METHODS

Patients who self-presented to Counties Manukau ED with a non-urgent condition in June 2019 were surveyed. Responses to open-ended questions were analysed using a general inductive approach, in discussion with key stakeholders.

RESULTS

Of 353 participants with ethnicity reported, 139 (39%) were Pacific, 66 (19%) Māori and 148 (42%) were non-Māori non-Pacific, nMnP. A total of 58 (42%) of Pacific participants had been to their general practitioner prior to presenting to the ED; this proportion was similar for Māori (19 [30%]) and nMnP (59 [40%]) (p=0.215). The most common reasons for ED attendance among Pacific (as well as other) participants were 1) advice by a health professional (41%, 95% CI 33-50%), 2) usual care unavailable (28%, 20-36%), 3) symptoms not improving (21%, 14-28%), and 4) symptoms too severe to be managed elsewhere (19%, 12-26%).

CONCLUSIONS

Multiple reasons underlie non-urgent use of EDs by Pacific and other ethnic groups. These reasons need to be considered simultaneously in the design, implementation, and evaluation of multi-dimensional initiatives that discourage non-urgent use of EDs to ensure that such initiatives are effective, equitable, and unintended consequences are avoided.

摘要

目的

确定太平洋患者在 Counties Manukau Health 因非紧急情况前往急诊部（ED）的原因。

方法

2019 年 6 月，对因非紧急情况自行前往 Counties Manukau ED 的患者进行了调查。对开放式问题的回答采用一般归纳法进行分析，并与主要利益攸关方进行了讨论。

结果

在所报告的 353 名具有种族背景的参与者中，有 139 名（39%）为太平洋人，66 名（19%）为毛利人，148 名（42%）为非毛利非太平洋人（nMnP）。共有 58 名（42%）太平洋参与者在前往 ED 就诊前曾看过全科医生；毛利人（19 [30%]）和 nMnP（59 [40%]）的这一比例相似（p=0.215）。太平洋（以及其他）参与者前往 ED 的最常见原因是 1）健康专业人员的建议（41%，95%CI 33-50%），2）通常的护理不可用（28%，20-36%），3）症状没有改善（21%，14-28%），4）症状太严重无法在其他地方处理（19%，12-26%）。