Are patients who call a primary care office referred to the emergency department by non-healthcare personnel without the input of a physician?

PeerJ

article

Russell Hill¹  Albert Gest¹  Cynthia Smith¹  Jose H. Guardiola²  Michael Apolinario¹  Joann Ha¹  Jose R. Gonzalez³  Peter B. Richman¹ 

[1] Department of Emergency Medicine, Christus Spohn/Texas A&M Health Science Center;Department of Mathematics, Texas A&M University - Corpus Christi;Department of Internal Medicine, University of Texas Health Science Center Northeast-Good Shepherd Medical Center

关键词: Primary care referral;    Emergency department;    Utilization;   

DOI  :  10.7717/peerj.1507

学科分类：社会科学、人文和艺术（综合）

来源: Inra

【 摘 要 】

Objective. We hypothesized that a significant percentage of patients who are referred to the Emergency Department (ED) after calling their primary care physician’s (PCP) office receive such instructions without the input of a physician.Methods. We enrolled a convenience sample of stable adults at an inner-city ED. Patients provided written answers to structured questions regarding PCP contact prior to the ED visit. Continuous data are presented as means ± standard deviation; categorical data as frequency of occurrence. 95% confidence intervals were calculated.Results. The study group of 660 patients had a mean age of 41.7 ± 14.7 years and 72.6% had income below $20,000/year. 472 patients (71.51%; 67.9%–74.8%) indicated that they had a PCP. A total of 155 patients (23.0%; 19.9%–26.4%) called to contact their PCP prior to ED visit. For patients who called their PCP office and were directed by phone to the ED, the referral pattern was observed as follows: 31/98 (31.63%; 23.2%–41.4%) by a non-health care provider without physician input, 11/98 (11.2%; 6.2%–19.1%) by a non-healthcare provider after consultation with a physician, 12/98 (12.3%; 7.7%–20.3%) by a nurse without physician input, and 14/98 (14.3%; 8.6%–22.7%) by a nurse after consultation with physician. An additional 11/98, 11.2%; 6.2–19.1%) only listened to a recorded message and felt the message was directing them to the ED.Conclusion. A relatively small percentage of patients were referred to the ED without the consultation of a physician in our overall population. However, over half of those that contacted their PCP’s office felt directed to the ED by non-health care staff.

【 授权许可】

CC BY