scholarly journals Patient motives for contacting out-of-hours care in Denmark: a cross-sectional study

2019 ◽  
Author(s):  
Linda Huibers ◽  
Anders H Carlsen ◽  
Grete Moth ◽  
Helle C Christensen ◽  
Ingunn S Riddervold ◽  
...  
Keyword(s):  
Primary Care ◽  
Emergency Medical Services ◽  
Healthcare Service ◽  
Service Providers ◽  
Patient Characteristics ◽  
Medical Services ◽  
Cross Sectional ◽  
Out Of Hours ◽  
Emergency Medical ◽  
Acute Healthcare

Abstract Background Patients in need of acute healthcare do not always contact the most suitable healthcare service provider. Contacting out-of-hours primary care for an urgent problem may delay care, whereas contacting emergency medical services for a non-urgent problem could ultimately affect patient safety. More insight into patient motives for contacting a specific healthcare provider may help optimise patient flows. This study aims to explore patient motives for contacting out-of-hours primary care and the emergency medical services in Denmark. Methods We conducted a cross-sectional observational study by sending a questionnaires to patients contacting out-of-hours primary care and emergency medical services, both of which can be directly contacted by patients, in two of five Danish regions in 2015. As we aimed to focus on the first access point, the emergency department was not included. The questionnaire included items on patient characteristics, health problem and 26 pre-defined motives. Descriptive analyses of patient characteristics and motives were conducted, stratified by the two healthcare service providers. Factors associated with contacting each of the two service providers were explored in a modified Poisson regression analysis, and adjusted risk ratios were calculated. Results Three key motives for contacting the two service providers were identified: ‘unpleasant symptoms’, ‘perceived need for prompt action’ and ‘perceived most suitable healthcare provider’. Other important motives were ‘need arose outside office hours’ and ‘wanted to talk to a physician’ (out-of-hours primary care) and ‘expected need for ambulance’ and ‘worried’ (emergency medical services). Higher probability of contacting the emergency medical services versus out-of-hours primary care was seen for most motives relating to own assessment and expectations, previous experience and knowledge, and own needs and wishes. Lower probability was seen for most motives relating to perceived barriers and benefits. Conclusions Patient motives for contacting the two healthcare service providers were partly overlapping. The study contributes with new knowledge on the complex decision-making process of patients in need of acute healthcare. This knowledge could help optimise existing healthcare services, such as patient safety and the service level, without increasing healthcare costs.

scholarly journals Patient motives for contacting out-of-hours care in Denmark: a cross-sectional study

2020 ◽  
Author(s):  
Linda Huibers ◽  
Anders H Carlsen ◽  
Grete Moth ◽  
Helle C Christensen ◽  
Ingunn S Riddervold ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Emergency Medical Services ◽  
Service Providers ◽  
Care Service ◽  
Health Care Service ◽  
Medical Services ◽  
Cross Sectional ◽  
Out Of Hours ◽  
Emergency Medical

Abstract Background Patients in need of acute health care do not always contact the most suitable health care service provider. Contacting out-of-hours primary care for an urgent problem may delay care, whereas contacting emergency medical services for a non-urgent problem could ultimately affect patient safety. More insight into patient motives for contacting a specific health care provider may help optimise patient flows. This study aims to explore patient motives for contacting out-of-hours primary care and the emergency medical services in Denmark.Methods We conducted a cross-sectional observational study by sending a questionnaire to patients contacting out-of-hours primary care and emergency medical services, both of which can be directly contacted by patients, in two of five Danish regions in 2015. As we aimed to focus on the first access point, the emergency department was not included. The questionnaire included items on patient characteristics, health problem and 26 pre-defined motives. Descriptive analyses of patient characteristics and motives were conducted, stratified by the two health care service providers. Factors associated with contacting each of the two service providers were explored in a modified Poisson regression analysis, and adjusted risk ratios were calculated.Results Three key motives for contacting the two service providers were identified: ‘unpleasant symptoms’, ‘perceived need for prompt action’ and ‘perceived most suitable health care provider’. Other important motives were ‘need arose outside office hours’ and ‘wanted to talk to a physician’ (out-of-hours primary care) and ‘expected need for ambulance’ and ‘worried’ (emergency medical services). Higher probability of contacting the emergency medical services versus out-of-hours primary care was seen for most motives relating to own assessment and expectations, previous experience and knowledge, and own needs and wishes. Lower probability was seen for most motives relating to perceived barriers and benefits.Conclusions Patient motives for contacting the two health care service providers were partly overlapping. The study contributes with new knowledge on the complex decision-making process of patients in need of acute health care. This knowledge could help optimise existing health care services, such as patient safety and the service level, without increasing health care costs.

scholarly journals Patient motives for contacting out-of-hours care in Denmark: a cross-sectional study

2020 ◽  
Author(s):  
Linda Huibers ◽  
Anders H Carlsen ◽  
Grete Moth ◽  
Helle C Christensen ◽  
Ingunn S Riddervold ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Emergency Medical Services ◽  
Service Providers ◽  
Care Service ◽  
Health Care Service ◽  
Medical Services ◽  
Cross Sectional ◽  
Out Of Hours ◽  
Emergency Medical

Abstract Background Patients in need of acute health care do not always contact the most suitable health care service provider. Contacting out-of-hours primary care for an urgent problem may delay care, whereas contacting emergency medical services for a non-urgent problem could ultimately affect patient safety. More insight into patient motives for contacting a specific health care provider may help optimise patient flows. This study aims to explore patient motives for contacting out-of-hours primary care and the emergency medical services in Denmark. Methods We conducted a cross-sectional observational study by sending a questionnaire to patients contacting out-of-hours primary care and emergency medical services, both of which can be directly contacted by patients, in two of five Danish regions in 2015. As we aimed to focus on the first access point, the emergency department was not included. The questionnaire included items on patient characteristics, health problem and 26 pre-defined motives. Descriptive analyses of patient characteristics and motives were conducted, stratified by the two health care service providers. Factors associated with contacting each of the two service providers were explored in a modified Poisson regression analysis, and adjusted risk ratios were calculated. Results Three key motives for contacting the two service providers were identified: ‘unpleasant symptoms’, ‘perceived need for prompt action’ and ‘perceived most suitable health care provider’. Other important motives were ‘need arose outside office hours’ and ‘wanted to talk to a physician’ (out-of-hours primary care) and ‘expected need for ambulance’ and ‘worried’ (emergency medical services). Higher probability of contacting the emergency medical services versus out-of-hours primary care was seen for most motives relating to own assessment and expectations, previous experience and knowledge, and own needs and wishes. Lower probability was seen for most motives relating to perceived barriers and benefits. Conclusions Patient motives for contacting the two health care service providers were partly overlapping. The study contributes with new knowledge on the complex decision-making process of patients in need of acute health care. This knowledge could help optimise existing health care services, such as patient safety and the service level, without increasing health care costs.

scholarly journals Diverting less urgent utilizers of emergency medical services to primary care: is it feasible? Patient and morbidity characteristics from a cross-sectional multicenter study of self-referring respiratory emergency department consulters

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Felix Holzinger ◽  
Sarah Oslislo ◽  
Rebecca Resendiz Cantu ◽  
Martin Möckel ◽  
Christoph Heintze
Keyword(s):  
Primary Care ◽  
Emergency Medical Services ◽  
Logistic Model ◽  
Medical Services ◽  
Migrant Status ◽  
Cross Sectional ◽  
Out Of Hours ◽  
Emergency Medical ◽  
Access And Quality ◽  
Using Data

Abstract Objective Diversion of less urgent emergency medical services (EMS) callers to alternative primary care (PC) is much debated. Using data from the EMACROSS survey of respiratory ED patients, we aimed to characterize self-referred EMS patients, compare these with non-EMS patients, and assess scope and acceptability of a potential redirection to alternative PC. Results Of n = 292 self-referred patients, n = 99 were transported by EMS. Compared to non-EMS patients, these were older, triaged more urgently and arrived out-of-hours more frequently. The share of chronically and severely ill patients was greater. Out-of-hours ED visit, presence of a chronic pulmonary condition as well as a hospital diagnosis of respiratory failure were identified as determinants of EMS utilization in a logistic model, while consultation for access and quality motives as well as migrant status decreased the probability. EMS-transported lower urgency outpatients visiting during regular physicians’ hours were defined as potential PC cases and evaluated descriptively (n = 9). As a third was medically complex and potentially less suitable for PC, redirection potential could be estimated at only 6% of EMS cases. This would be reduced to 2% if considering patients’ judgment concerning the appropriate setting. Overall, the scope for PC diversion of respiratory EMS patients seems limited.

scholarly journals Sociodemographic Characteristics Associated with Contacts to Emergency Medical Services and Out-of-Hours Primary Care: An Observational Study of 2.3 Million Citizens

2020 ◽  
Vol Volume 12 ◽  
pp. 393-401
Author(s):  
Morten Breinholt Søvsø ◽  
Bodil Hammer Bech ◽  
Helle Collatz Christensen ◽  
Linda Huibers ◽  
Erika Frischknecht Christensen ◽  
...  
Keyword(s):  
Primary Care ◽  
Observational Study ◽  
Emergency Medical Services ◽  
Medical Services ◽  
Sociodemographic Characteristics ◽  
Out Of Hours ◽  
Emergency Medical

scholarly journals Use of the emergency medical services by patients with suspected acute primary healthcare problems: developing a questionnaire to measure patient trust in healthcare

2016 ◽  
Vol 4 (3) ◽  
pp. 444 ◽  
Author(s):  
Gabriella Norberg-Boysen ◽  
Lennart Christensson ◽  
Birgitta Wireklint-Sundström ◽  
Johan Herlitz ◽  
Maria Nyström ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Primary Healthcare ◽  
Service Providers ◽  
Medical Services ◽  
Patient Trust ◽  
Cross Sectional ◽  
Psychometric Instrument ◽  
Emergency Medical ◽  
Data Collections ◽  
Frontline Service

Rationale, aims and objectives The objective of this study is to develop a questionnaire measuring the level of trust and its constituents in patients calling the Emergency Medical Services for suspected acute primary healthcare problems. Four different frontline service providers were involved: the Dispatch Centre (DC), the Emergency Medical Services (EMS), the Emergency Department (ED) and the Healthcare Centre (HCC).Method The questionnaire was called the Patient Trust Questionnaire (PTQ). Repeated cross-sectional data collections were made and redundant items were gradually discarded. Finally, the constituents of trust were sought. Based on a literature review, the PTQ was developed as a psychometric instrument in four steps, as follows: 1) Item construction, 2) Face-to-face evaluation of items, 3) Item reduction, 4) Test of factor structure. The inclusion criteria for participating were that the patient must be 18 years of age or older and suspected having an acute primary healthcare problem when calling the EMS. In developing the questionnaire, 427 patients were included.Results Eight items remained for each frontline service provider in the PTQ, and two constituents of trust were found: credibility and accessibility.Conclusion A new measuring instrument has been developed for this particular healthcare chain, for patients with suspected acute primary healthcare problems calling the EMS. The two constituents of trust, credibility and accessibility, are assumed to be specific for this particular healthcare chain.

Triage Ability of Emergency Medical Services Providers and Patient Disposition: A Prospective Study

1999 ◽  
Vol 14 (3) ◽  
pp. 67-72 ◽  
Author(s):  
John R. Richards ◽  
Stephen J. Ferrall
Keyword(s):  
Chest Pain ◽  
Emergency Medical Services ◽  
Patient Characteristics ◽  
University Hospital ◽  
Medical Services ◽  
Shortness Of Breath ◽  
Study Objective ◽  
Patient Disposition ◽  
Emergency Medical ◽  
Respiratory Complaints

AbstractStudy objective:To determine the ability of emergency medical services (EMS) providers to subjectively triage patients with respect to hospital admission and to determine patient characteristics associated with increased likelihood of admission.Methods:A prospective, cross-sectional study of a consecutive sample of patients arriving by ambulance during the month of February 1997 at an urban, university hospital, Emergency Department. Emergency medical services providers completed a questionnaire asking them to predict admission to the hospital and requested patient demographic information. Predictions were compared to actual patient disposition.Results:A total of 887 patients were included in the study, and 315 were admitted to the hospital (36%). With respect to admission, emergency medical services providers had an accuracy rate of 79%, with a sensitivity of 72% and specificity of 83% (kappa = 0.56). Blunt traumatic injury and altered mental status were the most common medical reasons for admission. Variables significantly associated with high admission rates were patients with age > 50 years, chest pain or cardiac complaints, shortness of breath or respiratory complaints, Medicare insurance, and Hispanic ethnicity. The emergency medical services providers most accurately predicted admission for patients presenting with labor (kappa = 1.0), shortness of breath / respiratory complaints (kappa = 0.84), and chest pain (kappa = 0.77).Conclusion:Emergency medical services providers can predict final patient disposition with reasonable accuracy, especially for patients presenting with labor, shortness of breath, or chest pain. Certain patient characteristics are associated with a higher rate of actual admission.

Feedback to Emergency Medical Services Providers: The Good, the Bad, and the Ignored

1997 ◽  
Vol 12 (2) ◽  
pp. 74-77 ◽  
Author(s):  
Elisabeth F. Mock ◽  
Keith D. Wrenn ◽  
Seth W. Wright ◽  
T. Chadwick Eustis ◽  
Corey M. Slovis
Keyword(s):  
Emergency Department ◽  
Emergency Medical Services ◽  
Emergency Medical Service ◽  
Medical Service ◽  
Service Providers ◽  
Medical Services ◽  
Emergency Medical Service System ◽  
Constructive Feedback ◽  
Emergency Medical ◽  
Emergency Medical Service Provider

AbstractHypothesis:To determine the type and frequency of immediate unsolicited feedback received by emergency medical service (EMS) providers from patients or their family members and emergency department (ED) personnel.Methods:Prospective, observational study of 69 emergency medical services providers in an urban emergency medical service system and 12 metropolitan emergency departments. Feedback was rated by two medical student observers using a prospectively devised original scale.Results:In 295 encounters with patients or family, feedback was rated as follows: 1) none in 224 (76%); 2) positive in 51 (17%); 3) negative in 19 (6%); and 4) mixed in one (<1%). Feedback from 254 encounters with emergency department personnel was rated as: 1) none in 185 (73%); 2) positive in 46 (18%); 3) negative in 21 (8%); and 4) mixed in 2 (1%). Patients who had consumed alcohol were more likely to give negative feedback than were patients who had not consumed alcohol. Feedback from emergency department personnel occurred more often when the emergency medical service provider considered the patient to be critically ill.Conclusion:The two groups provided feedback to emergency medical service providers in approximately one quarter of the calls. When feedback was provided, it was positive more than twice as often as it was negative. Emergency physicians should give regular and constructive feedback to emergency medical services providers more often than currently is the case.

scholarly journals The Role of Emergency Medical Services in Geriatrics: Bridging the Gap between Primary and Acute Care

CJEM ◽  
2015 ◽  
Vol 18 (1) ◽  
pp. 54-61 ◽  
Author(s):  
Judah Goldstein ◽  
Jennifer McVey ◽  
Stacy Ackroyd-Stolarz
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Emergency Medical Services ◽  
Acute Care ◽  
Functional Independence ◽  
Adverse Outcomes ◽  
Medical Services ◽  
Care Needs ◽  
Frail Older Adults ◽  
Emergency Medical

AbstractCaring for older adults is a major function of emergency medical services (EMS). Traditional EMS systems were designed to treat single acute conditions; this approach contrasts with best practices for the care of frail older adults. Care might be improved by the early identification of those who are frail and at highest risk for adverse outcomes. Paramedics are well positioned to play an important role via a more thorough evaluation of frailty (or vulnerability). These findings may inform both pre-hospital and subsequent emergency department (ED) based decisions. Innovative programs involving EMS, the ED, and primary care could reduce the workload on EDs while improving patient access to care, and ultimately patient outcomes. Some frail older adults will benefit from the resources and specialized knowledge provided by the ED, while others may be better helped in alternative ways, usually in coordination with primary care. Discerning between these groups is a challenge worthy of further inquiry. In either case, care should be timely, with a focus on identifying emergent or acute care needs, frailty evaluation, mobility assessments, identifying appropriate goals for treatment, promoting functional independence, and striving to have the patient return to their usual place of residence if this can be done safely. Paramedics are uniquely positioned to play a larger role in the care of our aging population. Improving paramedic education as it pertains to geriatrics is a critical next step.

National study of emergency medical services core competencies in Saudi Arabia

2020 ◽  
Vol 9 (3) ◽  
pp. 245-255
Author(s):  
Talal AlShammari ◽  
Paul Jennings ◽  
Brett Williams
Keyword(s):  
Saudi Arabia ◽  
Emergency Medical Services ◽  
Core Competencies ◽  
Healthcare Providers ◽  
Core Competency ◽  
Medical Services ◽  
National Study ◽  
Cross Sectional ◽  
Content Type ◽  
Emergency Medical

PurposeEmergency medical services (EMS) educational standards in Saudi Arabia have developed at an unprecedented rate, and the rapid pace of development has resulted in a considerable disparity of educational approaches. Therefore, an empirically based core competency framework should be developed. The aim was to utilize exploratory factor analysis (EFA) in the reduction and generation of a theoretical Saudi competency model.Design/methodology/approachA purposive sample was utilized in a national quantitative cross-sectional study design of Saudi Red Crescent Authority (SRCA) healthcare workers. The instrument comprised 41 core competency items rated on a Likert scale. EFA alpha factoring with oblique promax rotation was applied to the 41 items.FindingsA total of 450 EMS healthcare providers participated in the study, of whom 422 (93.8 per cent) were male and 28 (6.2 per cent) female. Of the participants, 230 (60 per cent) were aged 29–39 years and 244 (54.2 per cent) had 5–9 years of experience. An EFA of instrument items generated five factors: professionalism, preparedness, communication, clinical and personal with an eigenvalue > 1, representing 67.5 per cent of total variance. Only variables that had a loading value >0.40 were utilized in the factor solution.Originality/valueThe EFA model Saudi ParamEdic Competency Scale (SPECS) has been identified, with 27 core competency items and five overarching factors. The model has considerable similarities to other medical competency frameworks. However, some aspects are specifically unique to the Saudi EMS context. The SPECS model provides an academic blueprint that can be used by paramedic educational programs to ensure empirical alignment with the needs of the industry and community.

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