AN ANALYSIS OF EMERGENCY DEPARTMENT USE BY PATIENTS WITH MINOR ILLNESS

被引：91

作者：

SHESSER, R

KIRSCH, T

SMITH, J

HIRSCH, R

机构：

[1] Department of Emergency Medicine, Washington, DC

[2] Health Care Sciences, George Washington University, Washington, DC

[3] George Washington-Georgetown Emergency Medicine Residency, Washington, DC

来源：

ANNALS OF EMERGENCY MEDICINE | 1991年 / 20卷 / 07期

关键词：

minor illness; emergency department use;

D O I：

10.1016/S0196-0644(05)80835-2

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Study objective: To describe the motivation for emergency department use by patients with minor illnesses and compare the demographics and social class characteristics of these patients with those of the general ED population. Design: Observational, case-control study. Setting: Urban ED. Type of participants: A sample group of 325 adult, nongeriatric patients with minor illnesses was selected by screening all patients registering in the ED between 9:00 AM and 6:00 PM on 15 randomly selected weekdays. A patient was included in this study group if the chief complaint, method of arrival, and subsequent evaluation met predetermined criteria for minor illness. A comparison group (control) was composed of all ED patients (224) who presented during two randomly selected 24-hour periods that did not overlap with the times of study group enrollment. Interventions: Sample group patients were interviewed concerning their socioeconomic backgrounds, reasons for using the ED, and perceptions of the urgency of their conditions. Comparison group patients' interviews were confined to the collection of demographic and socioeconomic information. Measurements and main results: There were more men (P = .12), more self-pay patients (P = .017), and fewer Medicare patients (P < .001) in the study group. There also was a strong trend toward higher income (P = .059) in the study group. The racial, marital, employment, and educational backgrounds of the two groups were similar. Eighty-two percent of the study group had no chronic illness, and only 36% reported a problem of more than three days' duration. Patients chose to use the ED because of its convenience (23.7%), the absence of previous provider relationships (22.1%), and the inability to make a prompt appointment with their regular provider (19.0%). Major differences existed between the reasons for which different demographic and socioeconomic groups chose ED care. Study group patients believed that less than 24 hours should elapse between the onset of their problem and the time at which they receive medical care. Conclusion: There are no major differences in ED use for minor illness patients from different racial, educational, and economic backgrounds. These patients tend to have a low frequency of chronic illness and often have no established health care provider. They choose the ED for its ease of access and the wide scope of care that can be delivered.

引用

页码：743 / 748

页数：6

共 36 条

[11]

Paneth, Bell, Stein, Emergency room utilization in the first 15 months of life: A randomized study, Pediatrics, 63, pp. 486-490, (1979)

[12]

Hochheiser, Woodward, Chamery, Effect of the neighborhood health center on the use of pediatric emergency departments in Rochester, New York, N Engl J Med, 285, pp. 148-152, (1971)

[13]

Jones, Jones, Yoder, Hospital location as a determinant of emergency room utilization patterns, Public Health Rep, 97, pp. 445-451, (1982)

[14]

O'Grady, Manning, Newhouse, Et al., The impact of cost sharing on emergency department use, N Engl J Med, 313, pp. 484-490, (1985)

[15]

Lavenhar, Ratner, Weinerman, Social class and medical care Indices of nonurgency in use of hospital emergency services, Medical Care, 6, pp. 368-380, (1968)

[16]

Badgett, Can Medicaid format alter emergency department utilization patterns?, Pediatric Emergency Care, 2, pp. 67-70, (1986)

[17]

Christoffel, Garside, Tokich, Has Medicaid promoted needless pediatric emergency department use?, Pediatr Emerg Care, 1, pp. 22-27, (1985)

[18]

Baum, Rubenstein, Old people in the emergency room: Age-related differences in emergency department use and care, J Am Geriatr Soc, 35, pp. 398-404, (1987)

[19]

Torrens, Yedvab, Variations among emergency room populations: A comparison of four hospitals in New York City, Med Care, 8, pp. 60-75, (1970)

[20]

Kooiman, Van de Wetering, Van der mast, Clinical and demographic characteristics of emergency department patients in The Netherlands, Am J Emerg Med, 7, pp. 632-638, (1989)

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