von Insa Seeger ; Andreas Klausen ; Stefan Thate ; Frank Flake ; Oliver Peters ; Walter Rempe ; Michael Peter ; Frank Scheinichen ; Ulf Günther ; Rainer Röhrig ; Andreas Weyland
Seit einigen Jahren steigen die Patientenzahlen in Notaufnahmen und Rettungsdiensten stetig an, doch nicht alle Patienten benötigen die Ressourcen eines Krankenhauses. Im Rahmen dieser Dissertation wurden drei unterschiedliche Studien zur ambulanten Notfallversorgung in Zentralen Notaufnahmen (ZNA) und ärztlichen Bereitschaftsdienstpraxen (BDP) durchgeführt. Es zeigt sich, dass viele Patienten nicht zwischen den Zuständigkeiten von ZNA und BDP differenzieren können. Ferner deckt sich die subjektive Beurteilung der Dringlichkeit aus Sicht der Patienten häufig nicht mit der Behandlungsdringlichkeit aus Sicht der Ärzte. Eine steigende Anspruchshaltung, mangelnde Gesundheitskompetenz sowie die Zugänglichkeit zu den Ressourcen spielen ebenfalls eine große Rolle. Es wurde ein Lösungsansatz erarbeitet, der zur Optimierung der Patientensteuerung beiträgt und die Notfallversorgung entlasten kann, wenn die dafür notwendigen strukturellen und politischen Rahmenbedingungen geschaffen werden. <dt.>
The number of patients in emergency departments and emergency rescue services is rising steadily. Nevertheless, but not all patients need the resources of a hospital. Three different studies on outpatient emergency care in emergency departments and out of hours (OOH) primary care centres were conducted as part of this dissertation. The results show that a lot of patients cannot differentiate between the responsibilities of emergency departments and OOH primary care centres. In addition, the subjective assessment of the urgency depends on the respective patient and often does not concur with the urgency of treatment from the physicians' point of view. Increasing expectations, a lack of health literacy, the accessibility and equipment also play an important role. A solution was developed to guide patients in a targeted manner. If the necessary political and structural framework conditions are created, then the outpatient emergency care can be relieved. <engl.>
Seit einigen Jahren steigen die Patientenzahlen in Notaufnahmen und Rettungsdiensten stetig an, doch nicht alle Patienten benötigen die Ressourcen eines Krankenhauses. Im Rahmen dieser Dissertation wurden drei unterschiedliche Studien zur ambulanten Notfallversorgung in Zentralen Notaufnahmen (ZNA) und ärztlichen Bereitschaftsdienstpraxen (BDP) durchgeführt. Es zeigt sich, dass viele Patienten nicht zwischen den Zuständigkeiten von ZNA und BDP differenzieren können. Ferner deckt sich die subjektive Beurteilung der Dringlichkeit aus Sicht der Patienten häufig nicht mit der Behandlungsdringlichkeit aus Sicht der Ärzte. Eine steigende Anspruchshaltung, mangelnde Gesundheitskompetenz sowie die Zugänglichkeit zu den Ressourcen spielen ebenfalls eine große Rolle. Es wurde ein Lösungsansatz erarbeitet, der zur Optimierung der Patientensteuerung beiträgt und die Notfallversorgung entlasten kann, wenn die dafür notwendigen strukturellen und politischen Rahmenbedingungen geschaffen werden.
The number of patients in emergency departments and emergency rescue services is rising steadily. Nevertheless, but not all patients need the resources of a hospital. Three different studies on outpatient emergency care in emergency departments and out of hours (OOH) primary care centres were conducted as part of this dissertation. The results show that a lot of patients cannot differentiate between the responsibilities of emergency departments and OOH primary care centres. In addition, the subjective assessment of the urgency depends on the respective patient and often does not concur with the urgency of treatment from the physicians' point of view. Increasing expectations, a lack of health literacy, the accessibility and equipment also play an important role. A solution was developed to guide patients in a targeted manner. If the necessary political and structural framework conditions are created, then the outpatient emergency care can be relieved.
Background: Due to the increasing number of non-urgent visits to emergency departments, it is becoming increasingly important to also investigate emergency care in out-of-hours (OOH) primary care. The aim of this study was to provide an insight into the care structures of an OOH primary care centre, to evaluate the reasons for encounter (RFE) and to assess the urgency of the treatment from the physicians´ point of view. Methods: In the summer of 2017, we conducted a cross-sectional study over four weeks in the OOH primary care centre of Oldenburg, a city in Lower Saxony with about 160,000 inhabitants. We collected socio-demographic data, RFE and the duration of the complaints. The International Classification for Primary Care 2nd Edition (ICPC-2) was used to categorize symptoms. The attending physicians supplemented information on further treatment (including hospitalization) and the urgency of consultation in the OOH primary care centre. Results: A total of 892 of the 1098 OOH patients which were visiting the OOH primary care centre took part in the study (participation: 81.2%). More than half of the patients were between 18 and 39 years old. A quarter of all RFE named by study participants were in the ICPC-2 category “skin”. More than 60% of patients had the symptoms for more than two days before visiting the OOH primary care centre. In 34.5% of all cases no medication was prescribed and one in six patients received further diagnostic tests such as urinalysis and blood tests (15.8%). From the physicians’ point of view, 26.3% of all study participants could have been treated by the family doctor during the regular consultation hours. Conclusion: The study shows that in the OOH primary care centre about a quarter of all patients could have waited until regular consultation hours. Mostly young patients used the easily accessible and free care in the OOH primary care centre. Further studies are necessary to better understand the individual reasons of patients to use the OOH primary care centre.
BMC family practice London : BioMed Central, 2000 Volume 20 (2019), number 1, article 41, Seite 1-10 Online-Ressource
Deutsche Gesellschaft für Medizinische Dokumentation, Informatik und Statistik German medical data sciences Amsterdam : IOS Press, 2017 (2017), Seite 65-69 1 Online-Ressource
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