Paris (AFP)
The unnecessary passages to emergencies are commonly accused of being responsible for the congestion of these services, but a French study tends to question this simplifying idea.
The study, published Wednesday in the journal British Medical Journal Quality & Safety, focused on a sample of 29,407 adult patients in France.
According to its results, the "inappropriate" use of emergencies is often associated with social vulnerability criteria.
Dr. Yuriyan Yordanov, emergency physician (Saint-Antoine Hospital, Paris AP-HP) coordinated the work conducted with the help of the French Society of Emergency Medicine (SFMU), Inserm and the Sorbonne Faculty of Medicine. University.
According to international publications, "inappropriate" emergency room visits in all countries would represent between 20% and 40% of all consultations, depending on how this term is defined.
In the new study, three measures were used and compared to try to define the appropriateness of the emergency department visit. Two subjective measures where the emergency physician was asked, firstly to assess the degree of adequacy of the remedy, on a scale from 0 to 10, then to say whether the request for care could have been taken in charge by a general practitioner the same day or the next day.
The third criterion related to the use of the resources of the service during the passage to the emergencies: for example a patient seen by a doctor, with a blood test and / or a radiological examination and a treatment corresponds a priori to a justified passage.
In the sample of 29,407 adults, inappropriate ERs accounted for "only 6% of passages" when considering all three criteria.
At the individual level, the likelihood of inadequate visitation decreases with the age of patients and with a home away from emergencies. On the other hand, it was more important in the absence of social security and supplementary insurance or mutual insurance.
Nearly 10% of patients said they came to the emergency room because there was no general practitioner available in town.
The study does not show any link with the departmental medical density. But the heterogeneity of the medical densities within a same department could explain the absence of link found.
"We spend our time making patients feel guilty." The study challenges the concept of inappropriate visits, which is commonly used to explain the overload of emergencies, when we are often dealing with socially and economically vulnerable patients. have no other choice, "Dr. Yordanov told AFP.
© 2019 AFP