Patient satisfaction with computer-assisted structured initial assessment facilitating patient streaming to emergency departments and primary care practices: results from a cross-sectional observational study accompanying the DEMAND intervention in Germany
Abstract Background Patient numbers in emergency departments are on the rise. The DEMAND intervention aims to improve the efficacy of emergency services by computer-assisted structured initial assessment assigning patients to emergency departments or primary care practices. The aims of our study wer...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-08-01
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| Series: | BMC Primary Care |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12875-022-01825-5 |
| _version_ | 1811188901735301120 |
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| author | Ingmar Schäfer Agata Menzel Tobias Herrmann Jan Hendrik Oltrogge Dagmar Lühmann Martin Scherer |
| author_facet | Ingmar Schäfer Agata Menzel Tobias Herrmann Jan Hendrik Oltrogge Dagmar Lühmann Martin Scherer |
| author_sort | Ingmar Schäfer |
| collection | DOAJ |
| description | Abstract Background Patient numbers in emergency departments are on the rise. The DEMAND intervention aims to improve the efficacy of emergency services by computer-assisted structured initial assessment assigning patients to emergency departments or primary care practices. The aims of our study were to evaluate patient satisfaction with this intervention and to analyse if reduced patient satisfaction is predicted by sociodemographic data, health status or health literacy. Methods We conducted a cross-sectional patient survey in emergency departments and co-located primary care practices. Each intervention site was planned to participate for two observation periods, each with a duration of one full week. Study participants were recruited by the local staff. The patients filled out a written questionnaire during their waiting time. Patient satisfaction was assessed by agreement to four statements on a four point Likert scale. Predictors of patient satisfaction were identified by multilevel, multivariable logistic regression models adjusted for random effects at the intervention site level. Results The sample included 677 patients from 10 intervention sites. The patients had a mean age of 38.9 years and 59.0% were women. Between 67.5% and 55.0% were fully satisfied with aspects of the intervention. The most criticised aspect was that the staff showed too little interest in the patients’ personal situation. Full satisfaction (“clearly yes” to all items) was reported by 44.2%. Reduced patient satisfaction (at least one item rated as “rather yes”, “rather no”, “clearly no”) was predicted by lower age (odds ratio 0.79 for ten years difference, 95% confidence interval 0.67/0.95, p = 0.009), presenting with infections (3.08,1.18/8.05,p = 0.022) or injuries (3.46,1.01/11.82,p = 0.048), a higher natural logarithm of the symptom duration (1.23,1.07/1.30,p = 0.003) and a lower health literacy (0.71 for four points difference, 0.53/0.94,p = 0.019). Conclusions The patients were for the most part satisfied with the intervention. Assessment procedures should be evaluated a) regarding if all relevant patient-related aspects are included; and whether patient information can be improved b) for patients with strong opinions about cause, consequences and treatment options for their health problem; and c) for patients who have problems in the handling of information relevant to health and healthcare. Trial registration German Clinical Trials Register ( https://www.drks.de/drks_web/setLocale_EN.do ) no. DRKS00017014. |
| first_indexed | 2024-04-11T14:26:00Z |
| format | Article |
| id | doaj.art-d987171f114e412e8c23aa88260cbeef |
| institution | Directory Open Access Journal |
| issn | 2731-4553 |
| language | English |
| last_indexed | 2024-04-11T14:26:00Z |
| publishDate | 2022-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Primary Care |
| spelling | doaj.art-d987171f114e412e8c23aa88260cbeef2022-12-22T04:18:52ZengBMCBMC Primary Care2731-45532022-08-0123111210.1186/s12875-022-01825-5Patient satisfaction with computer-assisted structured initial assessment facilitating patient streaming to emergency departments and primary care practices: results from a cross-sectional observational study accompanying the DEMAND intervention in GermanyIngmar Schäfer0Agata Menzel1Tobias Herrmann2Jan Hendrik Oltrogge3Dagmar Lühmann4Martin Scherer5Department of Primary Medical Care, University Medical Center Hamburg-EppendorfDepartment of Primary Medical Care, University Medical Center Hamburg-EppendorfaQua Institut für angewandte Qualitätsförderung und Forschung im Gesundheitswesen GmbHDepartment of Primary Medical Care, University Medical Center Hamburg-EppendorfDepartment of Primary Medical Care, University Medical Center Hamburg-EppendorfDepartment of Primary Medical Care, University Medical Center Hamburg-EppendorfAbstract Background Patient numbers in emergency departments are on the rise. The DEMAND intervention aims to improve the efficacy of emergency services by computer-assisted structured initial assessment assigning patients to emergency departments or primary care practices. The aims of our study were to evaluate patient satisfaction with this intervention and to analyse if reduced patient satisfaction is predicted by sociodemographic data, health status or health literacy. Methods We conducted a cross-sectional patient survey in emergency departments and co-located primary care practices. Each intervention site was planned to participate for two observation periods, each with a duration of one full week. Study participants were recruited by the local staff. The patients filled out a written questionnaire during their waiting time. Patient satisfaction was assessed by agreement to four statements on a four point Likert scale. Predictors of patient satisfaction were identified by multilevel, multivariable logistic regression models adjusted for random effects at the intervention site level. Results The sample included 677 patients from 10 intervention sites. The patients had a mean age of 38.9 years and 59.0% were women. Between 67.5% and 55.0% were fully satisfied with aspects of the intervention. The most criticised aspect was that the staff showed too little interest in the patients’ personal situation. Full satisfaction (“clearly yes” to all items) was reported by 44.2%. Reduced patient satisfaction (at least one item rated as “rather yes”, “rather no”, “clearly no”) was predicted by lower age (odds ratio 0.79 for ten years difference, 95% confidence interval 0.67/0.95, p = 0.009), presenting with infections (3.08,1.18/8.05,p = 0.022) or injuries (3.46,1.01/11.82,p = 0.048), a higher natural logarithm of the symptom duration (1.23,1.07/1.30,p = 0.003) and a lower health literacy (0.71 for four points difference, 0.53/0.94,p = 0.019). Conclusions The patients were for the most part satisfied with the intervention. Assessment procedures should be evaluated a) regarding if all relevant patient-related aspects are included; and whether patient information can be improved b) for patients with strong opinions about cause, consequences and treatment options for their health problem; and c) for patients who have problems in the handling of information relevant to health and healthcare. Trial registration German Clinical Trials Register ( https://www.drks.de/drks_web/setLocale_EN.do ) no. DRKS00017014.https://doi.org/10.1186/s12875-022-01825-5Emergency carePatient streamingEmergency department crowding |
| spellingShingle | Ingmar Schäfer Agata Menzel Tobias Herrmann Jan Hendrik Oltrogge Dagmar Lühmann Martin Scherer Patient satisfaction with computer-assisted structured initial assessment facilitating patient streaming to emergency departments and primary care practices: results from a cross-sectional observational study accompanying the DEMAND intervention in Germany BMC Primary Care Emergency care Patient streaming Emergency department crowding |
| title | Patient satisfaction with computer-assisted structured initial assessment facilitating patient streaming to emergency departments and primary care practices: results from a cross-sectional observational study accompanying the DEMAND intervention in Germany |
| title_full | Patient satisfaction with computer-assisted structured initial assessment facilitating patient streaming to emergency departments and primary care practices: results from a cross-sectional observational study accompanying the DEMAND intervention in Germany |
| title_fullStr | Patient satisfaction with computer-assisted structured initial assessment facilitating patient streaming to emergency departments and primary care practices: results from a cross-sectional observational study accompanying the DEMAND intervention in Germany |
| title_full_unstemmed | Patient satisfaction with computer-assisted structured initial assessment facilitating patient streaming to emergency departments and primary care practices: results from a cross-sectional observational study accompanying the DEMAND intervention in Germany |
| title_short | Patient satisfaction with computer-assisted structured initial assessment facilitating patient streaming to emergency departments and primary care practices: results from a cross-sectional observational study accompanying the DEMAND intervention in Germany |
| title_sort | patient satisfaction with computer assisted structured initial assessment facilitating patient streaming to emergency departments and primary care practices results from a cross sectional observational study accompanying the demand intervention in germany |
| topic | Emergency care Patient streaming Emergency department crowding |
| url | https://doi.org/10.1186/s12875-022-01825-5 |
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