Urgent health problems: the services patients choose and what influences their choices
DOI:
https://doi.org/10.32385/rpmgf.v18i5.9888Keywords:
Primary Health Care, Medical Emergencies, Health Service Users, Urgent Appointments, Emergency Departments, Patient?s Perceptions, Ambulatory Out-Of-Hours ClinicAbstract
Objectives: To characterise the use of medical services by patients who perceive their reason for encounter as urgent. Type of study: cross-sectional, observational, descriptive. Setting: Carnaxide Health Centre (HC). Population: Patient users of the Carnaxide HCs services. Methods: A self-applied questionnaire was used in a census sample of patients. Service use was studied: appointments with family doctor, non-personalised appointments at the HC, consultation at the HC ambulatory out-of-hours clinic, hospital emergency, and appointments with private doctors. Based on existing literature, factors influencing choice were selected: reasons for encounter, perceived seriousness, reasons for choice, sex, age, schooling, occupation, length of doctor-patient relationship, length of consultation, waiting time to access an urgent consultation with ones doctor, and telephone contact availability with ones family doctor (FD). Results: Two-hundred-and-fifty-six patients were studied, of which 35% saw their FD, 32% a hospital emergency department physician, 16% the HC out-of-hours clinic physician, and 7.8% the non-personalised consultation physician at the HC. Respiratory complaints were the most frequent reasons for encounter with the FD and at the out-of-hours clinic, whereas the cardiovascular system was predominant for the hospital emergency setting. The latter was used for reasons considered to be serious or very serious, whereas less serious reasons were given in greater proportion at the FDs consultations. The most frequent reason presented for the choice made was that the chosen setting was viewed as the most appropriate. However, geographical proximity and lack of awareness of alternatives were mentioned by 25 subjects as reasons for use of the hospital emergency department. Those patients who have to wait over one day for an urgent appointment with their FD preferentially used the hospital emergency department and the out-of-hours clinic. Conclusions: The results from this study suggest that it may be useful to make a community intervention in order to better inform and educate the patients to correctly use the available health services both at the hospital and at the HC.Downloads
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