Reasons for attending a general emergency outpatient clinic versus a regular general practitioner – a survey among immigrant and native walk-in patients in Oslo, Norway

Ruud, Sven Eirik; Hjortdahl, Per; Natvig, Bent

doi:10.1080/02813432.2017.1288817

Cited by 16 publications

(19 citation statements)

References 31 publications

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“…Similarly, depending on government welfare, immigrant and refugees may use ED free of charge. There were also other reasons that lead immigrants to ED such as language barriers and lack of accessing to primary care providers (15)(16)(17). Those reasons explain the high proportion of immigrant and refugees (8.7%) in frequent users in our study.…”

Section: Discussionmentioning

confidence: 74%

Retrospective Analyses of Frequent Emergency Department Users

Işık¹,

Tandoğan²,

Şafak³

et al. 2020

Eurasian J Emerg Med

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Aim: Emergency department (ED) demand and overcrowding is increasing worldwide, and a significant portion of this overcrowding is caused by ''frequent users''. The aim of the study is to define the characteristics of this group of patients who contribute towards a disproportionate number of ED visits. Materials and Methods: All ED visits during a 1-year period between 01 January 2018 and 31 December 2018 were retrospectively investigated using the electronic registration system of the hospital. Patients who visited the ED ≥4 times in this period were considered as ''frequent users''. Social history, disease and care-related factors of frequent users were investigated. Results: A total of 335,457 ED visits made in a calendar year (2018) were investigated. Frequents users comprised 6.8% of all ED patient population and 22.9% of all ED visits. Female gender proportion was greater among frequent users, and frequent users were younger than occasional users. Yellow/red triage code ratio was higher and the median length of hospital stay was significantly longer in the frequent users group. The proportion of uninsured patients was two times higher in the frequent users group, and half of these patients were immigrants or refugees. Conclusion: Frequent users place a significant burden on the increasing patient volume in EDs. Welfare status was an important indicator for being a frequent user. However, frequent users are a very heterogeneous patient group and more research is needed to better understand the factors leading to frequent ED use and to develop effective strategies to meet patients' complex health care needs.

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Section: Discussionmentioning

confidence: 74%

Retrospective Analyses of Frequent Emergency Department Users

Işık¹,

Tandoğan²,

Şafak³

et al. 2020

Eurasian J Emerg Med

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“…Fast track services are designed for patients seeking primary care services (often without a general practitioner) for less serious illnesses and injuries. International studies have suggested that immigrants use emergency services more for non-urgent health care problems than do native populations [ 16 , 35 , 36 ]. A Norwegian study reported that a frequent reason for not contacting a general practitioner before the emergency department was because it was difficult to access him.…”

Section: Discussionmentioning

confidence: 99%

Increased Urgent Care Center Visits by Southeast European Migrants: A Retrospective, Controlled Trial from Switzerland

Klukowska-Roetzler

Eracleous²,

Mûller

et al. 2018

IJERPH

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We investigated whether immigrants from Southeast Europe (SE) and Swiss patients have different reasons for visiting the emergency department (ED). Our retrospective data analysis for the years 2013–2017 describes the pattern of ED consultations for immigrants from SE living in Switzerland (Canton Bern), in comparison with Swiss nationals, with a focus on type of referral and reason for admission. A total of 153,320 Swiss citizens and 12,852 immigrants from SE were included in the study. The mean age was 51.30 (SD = 21.13) years for the Swiss patients and 39.70 (SD = 15.87) years for the SE patients. For some countries of origin (Albania, Bosnia and Herzegovina, and Turkey), there were highly statistically significant differences in sex distribution, with a predominance of males. SE immigrants had a greater proportion of patients in the lower triage level (level 3: SE: 67.3% vs. Swiss: 56.0%) and a greater proportion of patients in the high triage level than the Swiss population (level 1: SE: 3.4% vs. Swiss: 8.8%). SE patients of working age (16–65 years) were six times more often admitted by ambulance than older (≥65 years) SE patients, whereas this ratio was similar in the Swiss population. In both groups, the fast track service was primarily used for patients of working age (<65) and more than three times more often in the SE than the Swiss group (SE: 39.1%, Swiss: 12.6%). We identified some indications for access to primary care in emergency departments for immigrants and highlighted the need for attention to the role of organizational characteristics of primary health care in Switzerland. We highlighted the need for professional support to improve the quality of healthcare for immigrants. In the future, we will need more primary care services and general practitioners with a migrant background.

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“…Younger people, as well as non-nationals, might -on average -be less attached to their GPs or might not even have a personal GP, which leads to them seeking help at an ED rather than at GPs' practices when they need care urgently after an accident [24].…”

Section: Comparison With Related Literaturementioning

confidence: 99%

Recent Trends and Variations in General Practitioners’ Involvement in Accident Care in Switzerland: an Analysis of Claims Data

Höglinger

Knöfler²,

Stosch³

et al. 2020

Preprint

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BACKGROUND As in other countries, there is concern that GPs’ central role in the Swiss healthcare system as the primary provider of care might be changing or even be in decline. Our study gives a systematic account of GPs’ involvement in accident care from 2008 to 2016 and identifies changes in GPs’ involvement in this typical field of primary care: how frequently GPs were involved along the care pathway, to what extent they figured as initial care provider, and what their role in the care pathway was. METHODS Using a claims dataset from the largest Swiss accident insurer with two million accident cases, we constructed individual care pathways, i.e., when and from which providers patients received care. We calculated probabilities for the involvement of various care provider groups, for initial care provision, and for the role of GPs in patients’ care pathways, adjusted for injury and patient characteristics using multinomial regression. RESULTS In 2014, GPs were involved in 70% of all accident cases requiring outpatient care but no inpatient stay, and provided initial care in 56%. While involvement stayed at about the same level for accidents occurring from 2008 to 2014, the share of accidents where GPs provided initial care decreased by 4 percentage points. The share of cases where GPs acted as sole care provider decreased by 7 percentage points down to 44%. At the same time, accident cases involving care from an ED at any point in time increased from 38% to 46% and the share receiving initial care from an ED from 30 to 35 percentage points – apparently substituting for the declining involvement of GPs in initial care. GPs’ involvement in accident care is higher in rural compared to urban regions, among elderly compared to younger patients, and among Swiss compared to non-Swiss citizens. CONCLUSIONS GPs play a key role in accident care with considerable variation depending on region and patient profile. From 2008 to 2014, there is a remarkable decline in GPs’ provision of initial care after an accident. This is a strong indication that the GPs’ role in the Swiss healthcare system is changing.

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Reasons for attending a general emergency outpatient clinic versus a regular general practitioner – a survey among immigrant and native walk-in patients in Oslo, Norway

Cited by 16 publications

References 31 publications

Retrospective Analyses of Frequent Emergency Department Users

Retrospective Analyses of Frequent Emergency Department Users

Increased Urgent Care Center Visits by Southeast European Migrants: A Retrospective, Controlled Trial from Switzerland

Recent Trends and Variations in General Practitioners’ Involvement in Accident Care in Switzerland: an Analysis of Claims Data

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