Scripties UMCG - Rijksuniversiteit Groningen
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Patients´ motivation for using the Emergency Department instead of ambulatory medical institutionsResults of a questionnaire-based study among patients who visit the Emergency Department without hospitalization

(2018) Bode, L. (Lena)

Background: Rising numbers of cases in Emergency Departments (EDs) in Germany and
worldwide lead to access block and increased length of stay which might result in increased
mortality and morbidity of the patient. We aimed to find out the motives of patients to visit
the ED instead of ambulatory institutions.
Methods: An explorative study lasting seven weeks was conducted. Patients were recruited
who were assigned to the lowest two categories of the Manchester triage system and who
were not hospitalized by a doctor or brought by ambulance to the ED. Questionnaires were
handed out to the patient and were additionally filled out by the attending doctor. The data
was analysed using the software package IBM SPSS Statistics 24.
Results: 120 questionnaires were filled out by the patients and 94 were additionally
completed by the attending doctor. 79 patients (68.7%) tried to contact an ambulatory
institution before visiting the ED. Of these 26.6% said that they got a referral by the doctor
and 20.2% stated that they were sent to the hospital without hospitalization. The following
reasons were mentioned why patients did not contact ambulatory institutions
beforehand: practice was closed (47.4%) and better medical treatment in the ED available
(18.4%). 25.7% of the respondents stated that they are not familiar with the ambulatory
emergency service.
Conclusions: The results indicate that quite a lot of patients did seek help in the ambulatory
sector before visiting the ED. This manifests needed improvement of distribution of patients
by ambulatory institutions as well as an improved collaboration of all participants of
ambulatory medical care as well as hospitals. On the other hand education of patients is
needed regarding alternatives in case of no availability of the regular provider.

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