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Is it a matter of urgency? A survey of assessments by walk-in patients and doctors of the urgency level of their encounters at a general emergency outpatient clinic in Oslo, Norway

Overview of attention for article published in BMC Emergency Medicine, July 2016
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Title
Is it a matter of urgency? A survey of assessments by walk-in patients and doctors of the urgency level of their encounters at a general emergency outpatient clinic in Oslo, Norway
Published in
BMC Emergency Medicine, July 2016
DOI 10.1186/s12873-016-0086-1
Pubmed ID
Authors

Sven Eirik Ruud, Per Hjortdahl, Bård Natvig

Abstract

Emergency room (ER) use is increasing in several countries. Variability in the proportion of non-urgent ER visits was found to range from 5 to 90 % (median 32 %). Non-urgent emergency visits are considered an inappropriate and inefficient use of the health-care system because they may lead to higher expenses, crowding, treatment delays, and loss of continuity of health care provided by a general practitioner. Urgency levels of doctor-walk-in patient encounters were assessed based on their region of origin in a diverse Norwegian population. An anonymous, multilingual questionnaire was distributed to all walk-in patients at a general emergency outpatient clinic in Oslo during two weeks in September 2009. We analysed demographic data, patient-doctor assessments of the level of urgency, and the results of the consultation. We used descriptive statistics to obtain frequencies with 95 % confidence interval (CI) for assessed levels of urgency and outcomes. Concordance between the patients' and doctors' assessments was analysed using a Kendall tau-b test. We used binary logistic regression modelling to quantify associations of explanatory variables and outcomes according to urgency level assessments. The analysis included 1821 walk-in patients. Twenty-four per cent of the patients considered their emergency consultation to be non-urgent, while the doctors considered 64 % of encounters to be non-urgent. The concordance between the assessments by the patient and by their doctor was positive but low, with a Kendall tau-b coefficient of 0.202 (p < 0.001). Adjusted logistic regression analysis showed that patients from Eastern Europe (odds ratio (OR) = 3.04; 95 % CI 1.60-5.78), Asia and Turkey (OR = 4.08; 95 % CI 2.43-6.84), and Africa (OR = 8.47; 95 % CI 3.87-18.5) reported significantly higher urgency levels compared with Norwegians. The doctors reported no significant difference in assessment of urgency based on the patient's region of origin, except for Africans (OR = 0.64; 95 % CI 0.43-0.96). This study reveals discrepancies between assessments by walk-in patients and doctors of the urgency level of their encounters at a general emergency clinic. The patients' self-assessed perception of the urgency level was related to their region of origin.

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 54 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 54 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 12 22%
Researcher 6 11%
Student > Doctoral Student 5 9%
Student > Bachelor 4 7%
Student > Ph. D. Student 4 7%
Other 11 20%
Unknown 12 22%
Readers by discipline Count As %
Medicine and Dentistry 17 31%
Nursing and Health Professions 10 19%
Social Sciences 4 7%
Psychology 3 6%
Engineering 2 4%
Other 2 4%
Unknown 16 30%

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 18 July 2018.
All research outputs
#10,060,055
of 16,367,518 outputs
Outputs from BMC Emergency Medicine
#279
of 475 outputs
Outputs of similar age
#140,475
of 267,547 outputs
Outputs of similar age from BMC Emergency Medicine
#1
of 1 outputs
Altmetric has tracked 16,367,518 research outputs across all sources so far. This one is in the 36th percentile – i.e., 36% of other outputs scored the same or lower than it.
So far Altmetric has tracked 475 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.3. This one is in the 38th percentile – i.e., 38% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 267,547 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 44th percentile – i.e., 44% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them