Evolution over 11 years of the characteristics of walk-in patients at the emergency department of a university hospital in Brussels

Hysenbegasi, Merita; Hubloue, Ives; Vanobberghen, Rita; Kartounian, Jan; Devroey, Dirk

doi:10.25122/jml-2018-0053

Cited by 7 publications

(5 citation statements)

References 24 publications

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“…In addition to this, our study included only walk-in patients, thus leading to a selection bias. The median age of our population was similar to walk-in patients elsewhere [38].…”

Section: Strength and Weaknesses Of The Studysupporting

confidence: 60%

Use of telehealth and outcomes before a visit to the emergency department: a cross-sectional study on walk-in patients in Switzerland

et al. 2021

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AIMS OF THE STUDY: An increasing number of patients are using telehealth before contacting the healthcare system. If we are to optimise future telehealth strategies and adequately respond to patient needs, we need to know more about the frequency and characteristics of telehealth use. Our objectives were (i) to investigate whether patients use telehealth before consulting the emergency department (ED), (ii) to compare patients with and without use of telehealth, and (iii) to investigate adherence, confidence and satisfaction. MATERIALS AND METHODS:A survey was conducted among ED walk-in patients at a tertiary university hospital in Switzerland. Eligible patients were questioned about their use of telehealth before current presentation, during 30 shifts from 23 October to 15 December 2019. RESULTS: A total of 183 (43.9%) of 417 surveyed patients used telehealth, with the telephone being the most commonly used modality, especially among elderly patients. Patients using telehealth were more likely to be male (53.5%, p = 0.001) and were similar in age to non-users. Telehealth users tended to be better educated. Telehealth was predominantly used for semi-urgent non-traumatic diseases that did not lead to hospitalisation. All age groups expressed satisfaction with telehealth, trusted the recommendations and adhered to them. The main reason for "non-use" of telehealth was lack of knowledge. CONCLUSIONS: Lack of knowledge about telehealth opportunities and barriers in specific patient groups should be addressed to include all patients, and thus to exploit telehealth's many advantages.

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“…In addition to this, our study included only walk-in patients, thus leading to a selection bias. The median age of our population was similar to walk-in patients elsewhere [38].…”

Section: Strength and Weaknesses Of The Studysupporting

confidence: 60%

Use of telehealth and outcomes before a visit to the emergency department: a cross-sectional study on walk-in patients in Switzerland

et al. 2021

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“…Concerning purportedly less urgent ED visits, means of arrival provide a first indicator: walk-in patients are presumably less severely ill than those arriving by ambulance [17], as in the latter the necessity of ED treatment will usually have been either determined by a health care professional (e.g. referring physician), or the patient will have felt too severely afflicted to consider other transportation.…”

Section: Introductionmentioning

confidence: 99%

Self-referred walk-in patients in the emergency department – who and why? Consultation determinants in a multicenter study of respiratory patients in Berlin, Germany

Holzinger

Oslislo

Möckel

et al. 2020

BMC Health Serv Res

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Background Emergency department (ED) consultations are on the rise, and frequently consultations by non-urgent patients have been held accountable. Self-referred walk-in (SRW) consulters supposedly represent a predominantly less urgent patient population. The EMACROSS study aimed to explore consultation determinants and motives in SRW patients with respiratory symptoms. Methods Multicenter survey of adult ED patients with respiratory complaints in eight emergency departments in central Berlin, Germany. Secondary hospital records data including diagnoses was additionally assessed. Characteristics of SRW and non-SRW patients were compared. Determinants of SRW consultation were evaluated by binary logistic regression. Consultation motives were analyzed descriptively. As a supplemental approach, network analysis (lasso-regularized mixed graphical model) was performed to explore connections between consultation determinants, consultation features and motives. Results Between June 2017 and November 2018, n = 472 participants were included, the median age was 55 years (range 18–96), 53.2% of patients were male and n = 185 cases (39.2%) were SRW consulters. The SRW group showed lower proportions of potentially severe (pneumonia and respiratory failure, p < 0.001, χ2 test) and chronic pulmonary conditions. Determinants of SRW consultation identified by logistic regression were younger age (p < 0.001), tertiary education (p = 0.032), being a first-generation migrant (p = 0.002) or tourist (p = 0.008), having no regular primary care provider (p = 0.036) and no chronic pulmonary illness (p = 0.017). The area under the curve (AUC) for the model was 0.79. Personal distress and access problems in ambulatory care were stated most frequently as consultation motives in the SRW group; network analysis showed the scarcity of associations between demographic and medical SRW determinants and motives triggering the actual decision to consult. Conclusions As to “who” consults, this study identified demographic and medical predictors of SRW utilization. The said markers seem only remotely connected to “why” people decide for SRW visits. To alleviate ED crowding by addressing frequent SRW consultation motives, interventions focused on the ability for symptom self-assessment and at better-accessible alternative care seem sensible. Trial registration German Clinical Trials Register (DRKS00011930); date: 2017/04/25.

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“…Again, our study includes only walk-in patients, thus leading to a selection bias. The median age of our population was similar to that of walk-in patients elsewhere [25]. External validity of this study is limited as it is a single-centre study conducted in one region of Switzerland only.…”

Section: Strength and Weaknesses Of The Studymentioning

confidence: 74%

Telehealth use by walk-in patients who subsequently visited an academic emergency department: a repeated cross-sectional study during the COVID-19 summer 2021

Mettler¹,

Aebersold²,

Piazza³

et al. 2023

Swiss Med Wkly

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AIMS OF THE STUDY: During the COVID-19 pandemic, telehealth use increased worldwide in a variety of medical specialities and reached new population groups. A baseline survey of telehealth use prior to admission to the emergency department (ED) conducted before COVID-19 concluded that predominantly well-educated men used telehealth. It is unclear how COVID-19 changed the use of telehealth in Swiss emergency patients. We therefore aimed to investigate (i) the frequency of telehealth use during the pandemic, and (ii) how the pandemic has influenced telehealth use and users. MATERIALS AND METHODS: A repeated cross-sectional study was conducted among ED walk-in patients at a tertiary university hospital in Switzerland. The study took place one and a half years after the first confirmed COVID-19 case, during 30 shifts from 8 to 29 July 2021 and compared with the baseline survey conducted in 2019. Eligible patients were questioned about their use of, and attitudes to telehealth. RESULTS: A total of 1020 patients were screened for the COVID survey and 443 complete questionnaires were evaluated. A trend towards a general increase (+6.4%) in telehealth use was demonstrated (50.3%, n = 223 COVID survey vs 43.9%, n = 183 baseline survey; p = 0.058), with a shift to more female patients using telehealth in the COVID survey (female 54.9%, n = 124 vs 45.1%, n = 102; p = 0.052). During the pandemic, first use of telehealth was reported by 12.2% (n = 54) of patients, with a significant increase among patients with low educational status, and the latter patients often indicated that they did not plan to use telehealth after the pandemic. The perceived usefulness of telehealth and adherence to recommendations increased in the COVID survey compared with the baseline survey (adherence 90.3%, n = 149, vs 78.0%, n = 131; p = 0.002). CONCLUSION: We found a trend towards increased use of telehealth among Swiss ED patients. First-time users of telehealth were predominantly less educated and inclusion of these user groups may not be sustainable, as was indicated by the patients. COVID-19 led to greater adherence to telehealth recommendations and higher perceived usefulness. This could be due to the limited access to healthcare providers due to pandemic precautions. When offering telehealth, the needs of all patient groups must be considered, in order to ensure that telehealth provides the greatest benefit with lower barriers to use.

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Evolution over 11 years of the characteristics of walk-in patients at the emergency department of a university hospital in Brussels

Cited by 7 publications

References 24 publications

Use of telehealth and outcomes before a visit to the emergency department: a cross-sectional study on walk-in patients in Switzerland

Use of telehealth and outcomes before a visit to the emergency department: a cross-sectional study on walk-in patients in Switzerland

Self-referred walk-in patients in the emergency department – who and why? Consultation determinants in a multicenter study of respiratory patients in Berlin, Germany

Telehealth use by walk-in patients who subsequently visited an academic emergency department: a repeated cross-sectional study during the COVID-19 summer 2021

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