Patients' Perspective on Choosing the Emergency Department for Nonurgent Medical Care: A Qualitative Study Exploring One Reason for Overcrowding

Howard, Matthew S.; Davis, Barbara; Anderson, Crystal S.; Cherry, Diane; Koller, Patricia; Shelton, Derek

doi:10.1016/j.jen.2005.06.023

Cited by 109 publications

(95 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our sample reflected this profile, reporting complex health needs and a diversity of precipitants of ED use, including mental health, substance use and physical health concerns. It is well-documented that most frequent users have community-based primary care (Howard et al 2005;Hunt et al 2006;Lucas and Sanford 1998), and our participants were no exception. They identified challenges in timeliness of access and continuity of care as well as a lack of accessible, acceptable alternatives for mental health or addictions-related crises, even within a large urban centre and a system of universal health insurance.…”

Section: Discussionmentioning

confidence: 69%

“Hospital was the Only Option”: Experiences of Frequent Emergency Department Users in Mental Health

Wise-Harris

Pauly

Kahan

et al. 2016

Adm Policy Ment Health

102

135

View full text Add to dashboard Cite

The experiences of individuals with mental illness and addictions who frequently present to hospital emergency departments (EDs) have rarely been explored. This study reports findings from self-reported, quantitative surveys (n = 166) and in-depth, qualitative interviews (n = 20) with frequent ED users with mental health and/or substance use challenges in a large urban centre. Participants presented to hospital for mental health (35 %), alcohol/drug use (21 %), and physical health (39 %) concerns and described their ED visits as unavoidable and appropriate, despite feeling stigmatized by hospital personnel and being discharged without expected treatment. Supporting this population may require alternative service models and attention to staff training in both acute and community settings.

show abstract

Section: Discussionmentioning

confidence: 69%

“Hospital was the Only Option”: Experiences of Frequent Emergency Department Users in Mental Health

Wise-Harris

Pauly

Kahan

et al. 2016

Adm Policy Ment Health

102

135

View full text Add to dashboard Cite

show abstract

“…Numerous factors account for this evolution, with some differences according to countries and health care systems, but everywhere they are linked to a modification of the demand. 3,4 Moreover, it is not possible to sort out or triage patients out of the ED prior to a medical or nurse examination. 5 Many other elements besides ED management, such as an increase in patient load, closure of EDs, reduction in the number of general practitioners, and an aging population, have affected ED volumes and should be addressed on a regional scale.…”

mentioning

confidence: 99%

From Model to Forecasting: A Multicenter Study in Emergency Departments

Wargon

Casalino

Guidet

2010

Academic Emergency Medicine

View full text Add to dashboard Cite

Objectives: This study investigated whether mathematical models using calendar variables could identify the determinants of emergency department (ED) census over time in geographically close EDs and assessed the performance of long-term forecasts.Methods: Daily visits in four EDs at academic hospitals in the Paris area were collected from 2004 to 2007. First, a general linear model (GLM) based on calendar variables was used to assess two consecutive periods of 2 years each to create and test the mathematical models. Second, 2007 ED attendance was forecasted, based on a training set of data from 2004 to 2006. These analyses were performed on data sets from each individual ED and in a virtual mega ED, grouping all of the visits. Models and forecast accuracy were evaluated by mean absolute percentage error (MAPE). Results:The authors recorded 299,743 and 322,510 ED visits for the two periods, 2004-2005 and 2006-2007, respectively. The models accounted for up to 50% of the variations with a MAPE less than 10%. Visit patterns according to weekdays and holidays were different from one hospital to another, without seasonality. Influential factors changed over time within one ED, reducing the accuracy of forecasts. Forecasts led to a MAPE of 5.3% for the four EDs together and from 8.1% to 17.0% for each hospital.Conclusions: Unexpectedly, in geographically close EDs over short periods of time, calendar determinants of attendance were different. In our setting, models and forecasts are more valuable to predict the combined ED attendance of several hospitals. In similar settings where resources are shared between facilities, these mathematical models could be a valuable tool to anticipate staff needs and site allocation.ACADEMIC EMERGENCY MEDICINE 2010; 17:970-978 ª

show abstract

“…In der Folge verzeichnen insbesondere Notaufnahmen in deutschen Krankenhäusern eine steigende Nachfrage der vorgehaltenen Versorgungsstrukturen [24][25][26]. Auch in anderen Ländern berichten Studien und Untersuchungen von zunehmenden Patientenzahlen und dem Phänomen des "crowding" in Notaufnahmen, dessen Ursache zumindest teilweise auf den zunehmenden Anstieg von Haus-und Facharztpatienten und nicht dringlichen Behandlungen zurückgeführt wird [1,10,19].…”

Section: Hintergrund Und Fragestellungunclassified