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Observational Study
. 2017 Sep 29;114(39):645-652.
doi: 10.3238/arztebl.2017.0645.

Patients Attending Emergency Departments

Martin Scherer  1 , Dagmar Lühmann, Agata Kazek, Heike Hansen, Ingmar Schäfer
Affiliations
Observational Study

Patients Attending Emergency Departments

Martin Scherer et al. Dtsch Arztebl Int. .

Abstract

Background: The number of patients in emergency departments has risen steadily in recent years, with a particular increase in patients not requiring urgent treatment. The aim of this study is to characterize this group of patients with respect to their sociodemographic features, health status, and reasons for attending an emergency department.

Methods: PiNo Nord is a cross-sectional observational study representing two full working weeks in five different hospitals. Patients were questioned in personal interviews, and medical diagnoses were documented. The data were analyzed with multivariate logistic regressions in mixed multilevel models. Predictors for the subjectively perceived treatment urgency were identified by stepwise backward selection.

Results: The 1175 patients questioned had an average age of 41.8 years and 52.9% were male. 54.7% said the degree of their treatment urgency was low. 41.3% had visited the emergency department on their own initiative, 17.0% on the advice or referral of their primary care physician, and 8.0% on the advice or referral of a specialist. The strongest predictors for low subjective treatment urgency were musculoskeletal trauma (odds ratio [OR] 2.18), skin conditions (OR 2.15), and the momentary unavailability of a primary care physician (OR 1.70).

Conclusion: More than half of the patients do not think their condition requires urgent treatment and thus do not meet the definition of a medical emergency. Patients' reasons for visiting the emergency department are varied; aside from the treatment urgency of the health condition itself, the reason may lie in perceived structural circumstances and individual preferences.

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Figures

Figure 1
Figure 1
Recruitment process
Figure 2
Figure 2
Triage by hospital staff and patients‘ own perceptions of the treatment urgency (n = 1175) N/A, not available
Figure 3
Figure 3
Differences between patients with low (blue bars) and high (red bars) subjectively perceived treatment urgency; results of a multivariate logistic regression adjusted for random effects at the level of the federal states and hospitals (n = 950). ß, regression coefficient; OR, odds ratio; p, probability value
See this image and copyright information in PMC

Comment in

  • Manipulative Handling of Data.
    Stuckrad BV. Stuckrad BV. Dtsch Arztebl Int. 2018 Feb 2;115(5):65. doi: 10.3238/arztebl.2018.0065a. Dtsch Arztebl Int. 2018. PMID: 29439763 Free PMC article. No abstract available.
  • Inadequate Statistical Evaluation.
    Swalve-Bordeaux S. Swalve-Bordeaux S. Dtsch Arztebl Int. 2018 Feb 2;115(5):65. doi: 10.3238/arztebl.2018.0065b. Dtsch Arztebl Int. 2018. PMID: 29439764 Free PMC article. No abstract available.
  • No Primary Care Physician Available.
    Möckel M, Schmiedhofer M. Möckel M, et al. Dtsch Arztebl Int. 2018 Feb 2;115(5):65-66. doi: 10.3238/arztebl.2018.0065c. Dtsch Arztebl Int. 2018. PMID: 29439765 Free PMC article. No abstract available.
  • Unclear Group Formation.
    Waldeyer-Sauerland M. Waldeyer-Sauerland M. Dtsch Arztebl Int. 2018 Feb 2;115(5):66. doi: 10.3238/arztebl.2018.0066a. Dtsch Arztebl Int. 2018. PMID: 29439766 Free PMC article. No abstract available.

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