Exploring the views of low-acuity emergency department consulters on an educational intervention and general practitioner appointment service: a qualitative study in Berlin, Germany

Abstract

ObjectivesLow-acuity patients presenting to emergency departments (EDs) frequently have unmet ambulatory care needs. This qualitative study explores the patients’ views of an intervention aimed at education about care options and promoting primary care (PC) attachment.DesignQualitative telephone interviews were conducted with a subsample of participants of an interventional pilot study, based on a semi-structured interview guide. The data were analysed through qualitative content analysis.SettingThe study was carried out in three EDs in the city centre of Berlin, Germany.ParticipantsThirty-two low-acuity ED consulters with no connection to a general practitioner (GP) who had participated in the pilot study were interviewed; (f/m: 15/17; mean age: 32.9 years).InterventionIn the pilot intervention, ED patients with low-acuity complaints were provided with an information leaflet on appropriate ED usage and alternative care paths and they were offered an optional GP appointment scheduling service. Qualitative interviews explored the views of a subsample of the participants on the intervention.ResultsInterviewees perceived both parts of the intervention as valuable. Receiving a leaflet about appropriate ED use and alternatives to the ED was viewed as helpful, with participants expressing the desire for additional online information and a wider distribution of the content. The GP appointment service was positively assessed by the participants who had made use of this offer and seen as potentially helpful in establishing a long-term connection to GP care. The majority of patients declining a scheduled GP appointment expected no personal need for further medical care in the near future or preferred to choose a GP independently.ConclusionsLow-acuity ED patients seem receptive to information on alternative acute care options and prevailingly appreciate measures to encourage and facilitate attachment to a GP. Promoting PC integration could contribute to a change in future usage behaviour.Trial registration numberDRKS00023480.

“I do not know the advantages of having a general practitioner” - a qualitative study exploring the views of low-acuity emergency patients without a regular general practitioner toward primary care

“…The authors suggested that there should be services to enable patients to find a GP who meets their individual needs, arguing that this would increase GP attachment and continuity of care in the long term [ 34 ]. A targeted GP attachment program, as piloted in the interventional module of EMAPREPARE, could help to connect patients with GPs [ 20 ].…”

“…This can be very helpful in targeting future intervention approaches to promote PC attachment and continuity of care and in turn strengthen GP-mediated health literacy. Our EMAPREPARE pilot intervention is a first step in this direction, providing both information material about alternative care paths and an optional GP appointment scheduling service [ 20 ].…”

“…The project includes a pilot intervention and complementary qualitative interviews. The results and implications of the intervention have been reported in a previous publication [ 20 ]. Our paper presents findings on participants’ views and experiences of GP care from the qualitative interview study accompanying the intervention.…”

“…We tried to balance gender and intentionally over-represented participants willing to make use of the GP appointment service, which was part of the pilot intervention. Further information on sampling details can be found in a previous paper [ 20 ]. Patients who consented to a qualitative interview were called after ED discharge to schedule an interview appointment within two weeks after ED presentation to facilitate recall.…”

“…The final interview guide consisted of three parts (see Additional file 1 for complete interview guide). The results presented here correspond to the first part of the interview guide, which addressed patients' experiences and views about GP care (see Table 1), while parts two and three covered participants' views on the EMAPREPARE intervention, with results reported elsewhere [20]. During the interviews, questions were individually adapted to the conversation flow.…”