Télécharger le rapport (152 p.) - KCE
Télécharger le rapport (152 p.) - KCE
Télécharger le rapport (152 p.) - KCE
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104 Urgences <strong>KCE</strong> reports vol. 19B<br />
AUTHOR, YEAR<br />
COUNTRY<br />
LEE A. ET AL, 2003<br />
HONG KONG<br />
LEIBOWITZ R ET AL.<br />
2003<br />
AUSTRALIA<br />
LEUNG GM ET AL, 2001<br />
HONG KONG<br />
MARTIN BC, 2000<br />
USA<br />
STUDY DESIGN<br />
Cross-sectional<br />
Validation<br />
SAMPLE<br />
SETTING<br />
1 year<br />
randomly se<strong>le</strong>cted patients of A&E<br />
review Original studies and systematic review since<br />
1976<br />
Cross-sectional<br />
Conjoint analysis<br />
390 semi-urgent or non-urgent patients<br />
3 Eds<br />
Cross-sectional Data from clinical records, financial comparative<br />
analyses (3 non-emergent diagnosis)<br />
RESULT / CONCLUSION<br />
The most accurate unweighted nurses' triage classification had an average sensitivity of 87.8%,<br />
specificity of 83.9%, and a PPV of 70.1%. When weighted, the average sensitivity reduced to 75%,<br />
specificity to 65.7%, and PPV to 54%. The most accurate unweighted patients' self-triage<br />
classification yielded a sensitivity of 62.5%, specificity of 69.2%, and a PPV of 58.1%, and<br />
correspondingly reduced to 43.3, 49.2 and 38.6% if weights were applied.<br />
If a mechanism was put in place for additional screening on visitors with a borderline semi-urgent<br />
or non-urgent status, the nurses could safely reassign non-urgent patients to GP care.<br />
The rapid growth in te<strong>le</strong>phone triage and advice services appears to have the advantage of reducing<br />
immediate medical workload through the substitution of te<strong>le</strong>phone consultations for in-person<br />
consultations, and this has the potential to reduce costs. However, this has to be balanced with the<br />
finding of reduced patient satisfaction when in-person consultations are replaced by te<strong>le</strong>phone<br />
consultations.<br />
The relative importance attached to illness severity, waiting time, and consultation fee were 47.8%,<br />
33.6%, and 18.7%, respectively.<br />
Hong Kong patients are receptive to the concept of paral<strong>le</strong>l clinics.<br />
Conjoint analysis is a rigorous survey technique for eliciting the views of patients on health care<br />
services in the ED setting.<br />
Total cost higher in the ED due primarily to differences in ancillary tests and prescription