Subjective reasons why immigrant patients attend the emergency department

被引：17
作者：
Mahmoud I. [1 ]
Eley R. [2 ]
Hou X.-Y. [3 ]
机构：
[1] The University of Queensland, and School of Public Health and Social Work, Queensland University of Technology, Department of Emergency Medicine, Royal Brisbane and Women's Hospital-School of Medicine, Brisbane
[2] The University of Queensland, School of Medicine and the Department of Emergency Medicine- Princess Alexandra Hospital, Brisbane
[3] Queensland University of Technology, School of Public Health and Social Work, Brisbane
来源：
BMC Emergency Medicine | / 15卷 / 1期
关键词：
Emergency department; General practitioner; Immigrants;
D O I：
10.1186/s12873-015-0031-8
中图分类号：
学科分类号：
摘要：
Background: Some patients visit a hospital's emergency department (ED) for reasons other than an urgent medical condition. There is evidence that this practice may differ among patients from different backgrounds. The objective of this study was to examine the reasons why patients from a non-English speaking background (NESB) and patients with an English speaking background but not born in Australia (ESB-NBA) visit the ED, as compared to patients from English-speaking backgrounds but born in Australia (ESB-BA). Methods: A cross-sectional survey was conducted at the ED of a tertiary hospital in metropolitan Brisbane, Queensland, Australia. Over a four-month period patients who were assigned an Australasian Triage Scale score of 3, 4 or 5 were surveyed. Pearson chi-square test and multivariate logistic regression analyses were performed to examine the differences between the ESB and NESB patients' reported reasons for attending the ED. Results: A total of 828 patients participated in this study. Compared to ESB-BA patients NESB patients were less likely to consider contacting a general practitioner (GP) before attending the ED (Odds Ratios (OR) 0.6 (95% Confidence Interval (CI) 0.4-0.8, p<.05) While ESB-NBA were more likely to consider contacting a GP 1.7 (1.1-2.5, p<.05). Both the NESB patients and the ESB-NBA patients were far more likely than ESB-BA patients to report that they had visited the ED either because they do not have a GP (OR 7.9, 95% CI 4.7-13.4, p<.001) and 2.2 (95% CI 1.1-4.4, p<.05) respectively and less likely to think that the ED could deal with their problem better than a GP (OR 0.5 (95% CI 0.3-0.8, p<.05) and 0.7 (0.3-0.9, p<.05) respectively. The NESB patients also thought it would take too long to make an appointment to consult a GP (OR 6.2, 95% CI 3.7-10.4, p<0.001). Conclusions: NESB patients were the least likely to consider contacting a GP before attending hospital EDs. Educational interventions may help direct NESB people to the appropriate health services and therefore reduce the burden on tertiary hospitals ED. © Mahmoud et al.
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  • [1] DeShaw P.J., Use of the emergency department by Somali immigrants and refugees, Minn Med, 89, 8, (2006)
  • [2] Norredam M., Mygind A., Nielsen A.S., Bagger J., Krasnik A., Motivation and relevance of emergency room visits among immigrants and patients of Danish origin, Eur J Public Health, 17, 5, pp. 497-502, (2007)
  • [3] Oliver A., Mossialos E., Equity of access to health care: outlining the foundations for action, J Epidemiol Community Health, 58, 8, pp. 655-658, (2004)
  • [4] DeSalvo A., Rest S.B., Knight T., Nettleman M., Freer S., Patient education and emergency room visits, Clin Perform Qual Health Care, 8, 1, pp. 35-38, (2000)
  • [5] Pines J.M., Pollack C.V., Diercks D.B., Chang A.M., Shofer F.S., Hollander J.E., The association between emergency department crowding and adverse cardiovascular outcomes in patients with chest pain, Acad Emerg Med, 16, 7, pp. 617-625, (2009)
  • [6] Ackroyd-Stolarz S., Guernsey J.R., Mackinnon N., Kovacs G., The association between a prolonged stay in the emergency department and adverse events in older patients admitted to hospital: a retrospective cohort study, BMJ Qual Saf, 20, 7, pp. 564-569, (2011)
  • [7] Bolton M.B., Tilley B.C., Kuder J., Reeves T., Schultz L.R., The cost and effectiveness of an education program for adults who have asthma, J Gen Intern Med, 6, 5, pp. 401-407, (1991)
  • [8] Rodi S.W., Grau M.V., Orsini C.M., Evaluation of a fast track unit: alignment of resources and demand results in improved satisfaction and decreased length of stay for emergency department patients, Qual Manag Health Care, 15, 3, (2006)
  • [9] Baker D.W., Stevens C.D., Brook R.H., Patients who leave a public hospital emergency department without being seen by a physician, JAMA, 266, 8, pp. 1085-1090, (1991)
  • [10] Persons of non-English Speaking Background, (2008)
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