Télécharger le rapport (152 p.) - KCE
Télécharger le rapport (152 p.) - KCE
Télécharger le rapport (152 p.) - KCE
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<strong>KCE</strong> reports vol. 19B Urgences 101<br />
AUTHOR, YEAR<br />
COUNTRY<br />
DRUMMOND ET AL,<br />
2000<br />
UK<br />
FRANCO SM ET AL, 1997<br />
USA<br />
GORDON JA, 2001<br />
USA<br />
STUDY DESIGN<br />
SAMPLE<br />
SETTING<br />
Cross-sectional 1 week period<br />
Prospective study<br />
Program evaluation<br />
random 1:2 samp<strong>le</strong><br />
postal questionnaire<br />
sociodemografic data extracted from the service<br />
contact sheet<br />
Glasgow EMS<br />
Review of medical records<br />
Urban indigent pediatric population<br />
Cross-sectional over 24 hours consecutive patients (incl.<br />
ambulance)<br />
fall of 1997<br />
3EDs (urban public teaching hospital, a suburban<br />
university hospital, and a semirural community<br />
hospital)<br />
RESULT / CONCLUSION<br />
Two factors characterised as 'perceived prob<strong>le</strong>ms with daytime services' and 'perceived urgency'<br />
were identified.<br />
scores were higher in adults, in ma<strong>le</strong>s, among the non-affluent (particularly those resident in<br />
deprived areas), and in those presenting with a musculoske<strong>le</strong>tal prob<strong>le</strong>m. Scores on the latter<br />
dimension were significantly associated with age and presenting prob<strong>le</strong>m.<br />
Compared to those from affluent areas, patients from non-affluent areas appear to perceive<br />
difficulties accessing their general practitioner during surgery hours and may contact out-of-hours<br />
services as an alternative<br />
Parental experience, i.e. age and number of children, play a significant ro<strong>le</strong> in ED use<br />
KenPAC: 24-hour access to primary care physician + ED gatekeeping<br />
Ed visits declined (10% to 7.6%)<br />
Inappropriate visits dropped (41% to 8%)<br />
Thus gatekeeping activity contribute to reduce overall and inappropriate use of th ED<br />
Index of socioeconomic deprivation described by the US Census Bureau (based on food, housing,<br />
and utilities)<br />
Many ED patients suffer from fundamental social deprivations that threaten basic health. The most<br />
disadvantaged of these patients frequently lack contact with other medical care sites or public<br />
assistance networks.