Abstract
Background
In the Wesel District (North Rhine-Westphalia), emergency ambulances have been called out with increasing frequency and clinics report that their emergency departments (ED) are increasingly being used outside the consultation hours of panel doctors/compulsory health insurance (CHI) physicians. Therefore, the District Health Conference put this issue on its agenda.
Aims of the study
The aims were to obtain data on the following questions: 1. What do people do when they need medical help outside consultation hours of panel doctors? 2. Do people know that there is a duty panel doctor on call? Do they know how to contact this service? Do people know about the medical emergency service and phone number 112, and the new phone number 19222 for patient transport ambulances?
Material and methods
The study comprised all residents of the District of Wesel between 18 and 87 years of age (approximately 385,000 people). The sample contained 1089 persons drawn in accordance with the Gabler-Häder method and in a second step with the “birthday method”. The survey was carried out by the CATI (computer-assisted telephone interviews) laboratory at the Institute of Public Health (LÖGD, Bielefeld) between 18 February and 28 March 2002.
Results
On being asked “how would you act in case of a non-life-threatening disease outside consultation hours of panel doctors”, 48.6% of respondents were “correct” (i.e. on-call CHI duty physicians), while 51.5% of respondents were “incorrect”, for example “I go to the hospital/emergency department” (24.3%) or “I call the number 112” (13%). About 80% of respondents said they knew about on-call CHI duty physicians. More than 95% of respondents stated they knew about the emergency service of the fire department, and 86% of these respondents were able to recall the correct number 112. About 4% of the respondents said they knew the national telephone number for patient transport, and 58% of these respondents mentioned the correct number (19222).
Discussion
The tiered medical emergency system should be used properly. This aim could be achieved by: (1) informing the public about the 24-hour on-call service provided by panel doctors, that the majority of medical conditions can be treated by panel doctors, and in severe cases a professional and quick referral will be done, and that self-referral to hospital may reduce or even obstruct professional resources for the treatment of “real” emergency patients; (2) informing target groups (elderly people) about the emergency number 112; and (3) informing the public about the national number 19222 for patient transport. Structural measures include: (1) Specific on-call services, and (2) improvement in the transparency and reachability of panel doctors’ on-call services.
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References
Blöchliger C, Osterwalder J, Hatz C, et al (1998) Asylsuchende und Flüchtlinge in der Notfallstation. Soz- Präventivmed 43:39–48
Burchardi C, Angstwurm M, Endres S (2001) Diagnosespektrum in einer internistischen Notaufnahme. Internist 42:1462–1464
Cooper C, Simpson JM, Hanson R (2003) The district hospital emergency department: why do parents present? Emerg Med. 15(1):68–76
Flaig C, Zehnder K, Zürcher H, et al (2002) Selbsteinweisung ins Spital. Primary Care 2:280–283
Häder S, Gabler S (1998) Ein neues Stichprobendesign für telefonische Umfragen in Deutschland. In: Gabler S, Häder S, Hoffmeyer-Zlotnik JHP (eds) Telefonstichproben in Deutschland. Westdeutscher Verlag, Opladen
Heindel W, Datené S, Lauterbach K, Gandjour A (2003) Prospektive Observationsstudie zur Abdomen-Sonographie im radiologischen Bereitschaftsdienst einer Universitätsklinik: Ansätze zur Rationalisierung. In: RöFo – Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, pp 1207–1213
Hoepffner W, Wiemert B, Reitmann M, Raue W, et al (2000) Evaluation von ambulanten Versorgungsstrukturen – Beispiel der Inanspruchnahme des Notfalldienstes einer Universitätskinderpoliklinik. Monatsschr Kinderheilkd 148:470–474
Jaarsma-van Leeuwen I, Hamacher ER, Hirsch R, Janssens M (2000) Patients without referral treated in the emergency room: patient characteristics and motives. Ned Tijdschr Geneeskd 144(9):428–431
Klein-Lange M (1998) Ambulante Krankenversorgung. In: Schwartz FW, et al (eds) Das Public Health Buch. Urban und Schwarzenberg, Munich, pp 219–224
Kolip P (1998) Frauen und Männer. In: Schwartz FW, et al (eds) Das Public Health Buch. Urban und Schwarzenberg, Munich, pp 507–515
Kreis Wesel (2003) Statistischer Jahresbericht. Landrätin des Kreises Wesel
Laffoy M, O’Herlihy B, Keye G (1997) A profile of attenders to a south Dublin city accident and emergency department. Ir J Med Sci 166(1):35–37
LÖGD (2004) Gesundheitsindikatoren. Landesinstitut für den Öffentlichen Gesundheitsdienst NRW, Bielefeld, Heft 16
Marmot MG (1994) Social differentials in health within and between populations. Daedalus 123:197–216
Meer A, Simonin C, Trapp A, et al (2003) Einfluss der medizinschen computerassistierten Telefontriage auf das Patientenverhalten: erste Erfahrungen in der Schweiz. Schweizerische Ärztezeitung 84(41):2160–2165
Perez Solis D, Pardo de la Vega R, Fernandez Gonzalez N, Ibanez Fernandez A, Prieto Espunes S, Fanjul Fernandez JL (2003) Neonatal visits to a pediatric emergency service. An Pediatr 59(1):54–58
Peter R (2001) Berufsstatus und Gesundheit. In: Mielck A, Bloomfield K (eds) Sozial-Epidemiologie. Juventa, Weinheim Munich, pp 28–38
Rieffe C, Oosterveld P, Wijkel D, Wiefferink C (1999) Reasons why patients bypass their GP to visit a hospital emergency department. Accid Emerg Nurs 7(4):217–225
Siegrist J (1995) Soziale Einflüsse auf Gesundheit und Krankheit. In: Medizinische Soziologie. Urban und Schwarzenberg, Munich, Vienna, Baltimore, pp 157–99
Sixma HJ, de Bakker DH (1996) Hospital or general practice? Results of two experiments limiting the number of self referrals of patients with injuries to hospitals in the Netherlands. J Accid Emerg Med 13(4):264–268
Stolpe S (2001) Schulbildung/berufliche Ausbildung und Gesundheitszustand. In: Mielck A, Bloomfield K (eds) Sozial-Epidemiologie. Juventa, Weinheim Munich, pp 17–27
Turrell G, Mathers CD (2000) Socioeconomic status and health in Australia. Med J Aust 172:434–438
van Uden CJ, Winkens RA, Wesseling GJ, Crebolder HF, van Schayck CP (2003) Use of out of hours services: a comparison between two organisations. Emerg Med J 20(2):184–187
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Rau, R., Mensing, M. Use of medical emergency services. J Public Health 13, 166–173 (2005). https://doi.org/10.1007/s10389-005-0107-0
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DOI: https://doi.org/10.1007/s10389-005-0107-0