Children Who Leave the Emergency Department Without Being Seen: Why Did They Leave and What Would Make Them Stay?
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9962 |
Resumo: | Introduction: Children who visit emergency departments and leave without being seen represent a multifactorial problem. We aimed to compare the sociodemographic characteristics of children who left and of those who did not leave, as well as to evaluate parental reasoning, subsequent use of medical care and patient outcome.Material and Methods: This was a prospective case-control study of a random sample of children who left without being seen and their matched controls from an emergency department during a three-month period. We performed a phone questionnaire to obtain information concerning reasons for leaving, patient outcomes and general feedback.Results: During the study period, 18 200 patients presented to the emergency department, of whom 92 (0.5%) left without being seen. Fifty-five (59.8%) completed the questionnaire and there were 82 controls. The most common reasons for leaving were ‘excessive waiting time’ (92.7%) and ‘problem could wait’ (21.8%). A significantly higher number of patients who left sought further medical care (78.2% vs 11%) but they did not experience higher levels of unfavourable outcomes.Discussion: The waiting time seems to be the major factor that drives the decision to leave. The fact that parents felt safe in leaving and the low level of adverse outcomes highlights the low-acuity nature of the majority of patients who leave.Conclusion: Reducing the waiting times may be the logical strategic mean to decrease the rates of patients who leave without being seen. However, our data seems to indicate that the concerns surrounding clinical outcome after leaving may be partly unwarranted. |
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Children Who Leave the Emergency Department Without Being Seen: Why Did They Leave and What Would Make Them Stay?Abandono do Serviço de Urgência Pediátrico Antes da Observação Médica: Quais os Motivos e o Que o Teria Impedido?ChildEmergency ServiceHospitalOutcome Assessment (Health Care)Patient Acceptance of Health CarePatient DropoutsPortugalWaiting ListsAceitação pelo Doente de Cuidados de SaúdeAvaliação de Resultados (Cuidados de Saúde)CriançaListas de EsperaPortugalSaídas de DoentesServiço de Urgência HospitalarIntroduction: Children who visit emergency departments and leave without being seen represent a multifactorial problem. We aimed to compare the sociodemographic characteristics of children who left and of those who did not leave, as well as to evaluate parental reasoning, subsequent use of medical care and patient outcome.Material and Methods: This was a prospective case-control study of a random sample of children who left without being seen and their matched controls from an emergency department during a three-month period. We performed a phone questionnaire to obtain information concerning reasons for leaving, patient outcomes and general feedback.Results: During the study period, 18 200 patients presented to the emergency department, of whom 92 (0.5%) left without being seen. Fifty-five (59.8%) completed the questionnaire and there were 82 controls. The most common reasons for leaving were ‘excessive waiting time’ (92.7%) and ‘problem could wait’ (21.8%). A significantly higher number of patients who left sought further medical care (78.2% vs 11%) but they did not experience higher levels of unfavourable outcomes.Discussion: The waiting time seems to be the major factor that drives the decision to leave. The fact that parents felt safe in leaving and the low level of adverse outcomes highlights the low-acuity nature of the majority of patients who leave.Conclusion: Reducing the waiting times may be the logical strategic mean to decrease the rates of patients who leave without being seen. However, our data seems to indicate that the concerns surrounding clinical outcome after leaving may be partly unwarranted.Introdução: O abandono de doentes do serviço de urgência pediátrico antes da observação médica constitui um problema multifatorial. Procurámos comparar características sociodemográficas de crianças que abandonaram a urgência e das que não abandonaram, assim como avaliar os motivos, recurso subsequente a cuidados de saúde e outcome clínico.Material e Métodos: Estudo caso-controlo prospetivo de amostra aleatória de crianças que abandonaram a urgência e de controlos pareados durante um período de três meses. Foi realizado um questionário telefónico para recolha de informação relacionada com os motivos para o abandono, outcomes clínicos e opiniões gerais.Resultados: Durante o período do estudo, 18 200 doentes recorreram ao Serviço de Urgência Pediátrica, dos quais 92 (0,5%) abandonaram. Um total de 55 casos (59,8%) e 82 controlos completaram o questionário. As razões mais comuns para o abandono foram ‘tempo de espera excessivo’ (92,7%) e ‘problema podia esperar’ (21,8%). Um número significativamente superior de doentes que abandonaram recorreu subsequentemente a cuidados de saúde (78,2% vs 11%), não tendo contudo apresentado uma incidência superior de outcomes adversos.Discussão: O tempo de espera parece ser o fator prioritário que motiva a decisão de abandonar a urgência. A segurança referida pelos pais aquando da decisão e a incidência reduzida de outcomes adversos parecem reforçar a noção de que se trata de doentes com casos clínicos de baixa gravidade.Conclusão: A redução do tempo de espera parece ser a medida estratégica lógica para diminuir as taxas de abandono. No entanto, a preocupação associada ao outcome clínico após o abandono poderá ser parcialmente injustificada.Ordem dos Médicos2018-02-28info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/pdfapplication/pdfapplication/mswordhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9962oai:ojs.www.actamedicaportuguesa.com:article/9962Acta Médica Portuguesa; Vol. 31 No. 2 (2018): February; 109-114Acta Médica Portuguesa; Vol. 31 N.º 2 (2018): Fevereiro; 109-1141646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9962https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9962/5355https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9962/9837https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9962/9838https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9962/9979Direitos de Autor (c) 2018 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessSousa, RodrigoCorreia, CátiaValsassina, RitaMoeda, SofiaPaínho, TeresaOom, Paulo2022-12-20T11:05:51Zoai:ojs.www.actamedicaportuguesa.com:article/9962Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:19:46.772665Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Children Who Leave the Emergency Department Without Being Seen: Why Did They Leave and What Would Make Them Stay? Abandono do Serviço de Urgência Pediátrico Antes da Observação Médica: Quais os Motivos e o Que o Teria Impedido? |
title |
Children Who Leave the Emergency Department Without Being Seen: Why Did They Leave and What Would Make Them Stay? |
spellingShingle |
Children Who Leave the Emergency Department Without Being Seen: Why Did They Leave and What Would Make Them Stay? Sousa, Rodrigo Child Emergency Service Hospital Outcome Assessment (Health Care) Patient Acceptance of Health Care Patient Dropouts Portugal Waiting Lists Aceitação pelo Doente de Cuidados de Saúde Avaliação de Resultados (Cuidados de Saúde) Criança Listas de Espera Portugal Saídas de Doentes Serviço de Urgência Hospitalar |
title_short |
Children Who Leave the Emergency Department Without Being Seen: Why Did They Leave and What Would Make Them Stay? |
title_full |
Children Who Leave the Emergency Department Without Being Seen: Why Did They Leave and What Would Make Them Stay? |
title_fullStr |
Children Who Leave the Emergency Department Without Being Seen: Why Did They Leave and What Would Make Them Stay? |
title_full_unstemmed |
Children Who Leave the Emergency Department Without Being Seen: Why Did They Leave and What Would Make Them Stay? |
title_sort |
Children Who Leave the Emergency Department Without Being Seen: Why Did They Leave and What Would Make Them Stay? |
author |
Sousa, Rodrigo |
author_facet |
Sousa, Rodrigo Correia, Cátia Valsassina, Rita Moeda, Sofia Paínho, Teresa Oom, Paulo |
author_role |
author |
author2 |
Correia, Cátia Valsassina, Rita Moeda, Sofia Paínho, Teresa Oom, Paulo |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Sousa, Rodrigo Correia, Cátia Valsassina, Rita Moeda, Sofia Paínho, Teresa Oom, Paulo |
dc.subject.por.fl_str_mv |
Child Emergency Service Hospital Outcome Assessment (Health Care) Patient Acceptance of Health Care Patient Dropouts Portugal Waiting Lists Aceitação pelo Doente de Cuidados de Saúde Avaliação de Resultados (Cuidados de Saúde) Criança Listas de Espera Portugal Saídas de Doentes Serviço de Urgência Hospitalar |
topic |
Child Emergency Service Hospital Outcome Assessment (Health Care) Patient Acceptance of Health Care Patient Dropouts Portugal Waiting Lists Aceitação pelo Doente de Cuidados de Saúde Avaliação de Resultados (Cuidados de Saúde) Criança Listas de Espera Portugal Saídas de Doentes Serviço de Urgência Hospitalar |
description |
Introduction: Children who visit emergency departments and leave without being seen represent a multifactorial problem. We aimed to compare the sociodemographic characteristics of children who left and of those who did not leave, as well as to evaluate parental reasoning, subsequent use of medical care and patient outcome.Material and Methods: This was a prospective case-control study of a random sample of children who left without being seen and their matched controls from an emergency department during a three-month period. We performed a phone questionnaire to obtain information concerning reasons for leaving, patient outcomes and general feedback.Results: During the study period, 18 200 patients presented to the emergency department, of whom 92 (0.5%) left without being seen. Fifty-five (59.8%) completed the questionnaire and there were 82 controls. The most common reasons for leaving were ‘excessive waiting time’ (92.7%) and ‘problem could wait’ (21.8%). A significantly higher number of patients who left sought further medical care (78.2% vs 11%) but they did not experience higher levels of unfavourable outcomes.Discussion: The waiting time seems to be the major factor that drives the decision to leave. The fact that parents felt safe in leaving and the low level of adverse outcomes highlights the low-acuity nature of the majority of patients who leave.Conclusion: Reducing the waiting times may be the logical strategic mean to decrease the rates of patients who leave without being seen. However, our data seems to indicate that the concerns surrounding clinical outcome after leaving may be partly unwarranted. |
publishDate |
2018 |
dc.date.none.fl_str_mv |
2018-02-28 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
format |
article |
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publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9962 oai:ojs.www.actamedicaportuguesa.com:article/9962 |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9962 |
identifier_str_mv |
oai:ojs.www.actamedicaportuguesa.com:article/9962 |
dc.language.iso.fl_str_mv |
eng |
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eng |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9962 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9962/5355 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9962/9837 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9962/9838 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9962/9979 |
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Direitos de Autor (c) 2018 Acta Médica Portuguesa info:eu-repo/semantics/openAccess |
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Direitos de Autor (c) 2018 Acta Médica Portuguesa |
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openAccess |
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application/pdf application/pdf application/pdf application/msword |
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Ordem dos Médicos |
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Ordem dos Médicos |
dc.source.none.fl_str_mv |
Acta Médica Portuguesa; Vol. 31 No. 2 (2018): February; 109-114 Acta Médica Portuguesa; Vol. 31 N.º 2 (2018): Fevereiro; 109-114 1646-0758 0870-399X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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