Fischer-Rosinský Antje, Slagman Anna, Legg David, Wu Yves-Noel, King Ryan, Roll Stephanie, Keil Thomas, Möckel Martin
Health Services Research in Emergency and Acute Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
Health Services Research in Emergency and Acute Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany.
BMJ Open. 2024 Dec 20;14(12):e084986. doi: 10.1136/bmjopen-2024-084986.
Evidence suggests interventions targeting low-acuity attendances have been hampered by insufficient characterisation of potential target groups. This study aimed to estimate the frequency of low-acuity emergency department (ED) attendances and to provide an overview of their demographic, diagnosis and consultation patterns.
Observational analyses of routine healthcare data.
German EDs.
Adult patients with statutory health insurance who visited the ED of 16 participating hospitals in 2016.
Frequency, demographics, diagnoses and consultation patterns of low-acuity and high-acuity attendees.
Of the 454 747 ED visits, 370 756 visits (50.1% female) were included for analysis. Four participating hospitals had to be excluded due to the lack of data that were necessary for the stepwise approach to define low and high acuity. We identified 101 337 visits as low acuity (27.3%) and 256 876 as high acuity (69.3%), whereas 12 543 (3.4%) could not be classified. The proportion of attendees classified as low acuity decreased with age (highest at 40.6% in the age group <35 years). The proportion of women and men was 50% in both acuity categories, respectively (50 654 of all low-acuity and 128 427 of all high-acuity contacts). The highest proportion of low-acuity presentations was observed during the weekend (average of 18.6% per day), compared with an average of 12.5% on weekdays. The most common diagnoses (back pain, abdominal and pelvic pain) were similar in both low-acuity and high-acuity groups.
Our study provides further evidence that younger age is associated with low-acuity presentation in German EDs. Age-specific intervention strategies are needed to ease the burden on urgent care facilities. The similar spectrum of diagnoses between low-acuity and high-acuity patients suggests a so far under-recognised higher importance of severity.
DRKS00022969.
有证据表明，针对低急症就诊情况的干预措施因对潜在目标群体的特征描述不足而受到阻碍。本研究旨在估计低急症急诊科就诊的频率，并概述其人口统计学特征、诊断和就诊模式。
对常规医疗数据进行观察性分析。
德国急诊科。
2016年访问16家参与研究医院急诊科的法定医疗保险成年患者。
低急症和高急症就诊者的频率、人口统计学特征、诊断和就诊模式。
在454747次急诊科就诊中，纳入370756次就诊（女性占50.1%）进行分析。由于缺乏逐步定义低急症和高急症所需的数据，4家参与研究的医院被排除。我们确定101337次就诊为低急症（27.3%），256876次为高急症（69.3%），而12543次（3.4%）无法分类。被归类为低急症的就诊者比例随年龄下降（年龄<35岁组最高，为40.6%）。两个急症类别中女性和男性的比例均为50%（所有低急症就诊者中的50654次和所有高急症就诊者中的128427次）。与工作日平均12.5%相比，周末观察到的低急症就诊比例最高（平均每天18.6%）。低急症和高急症组最常见的诊断（背痛、腹部和盆腔疼痛）相似。
我们的研究提供了进一步的证据，表明在德国急诊科，年轻与低急症就诊相关。需要针对特定年龄的干预策略来减轻紧急护理设施的负担。低急症和高急症患者之间相似的诊断范围表明，严重程度的重要性迄今未得到充分认识。
DRKS00022969。
