Patients in need of acute health care do not always contact the most suitable health care service provider. Contacting out-of-hours primary care for an urgent problem may delay care, whereas contacting emergency medical services for a non-urgent problem could ultimately affect patient safety. More insight into patient motives for contacting a specific health care provider may help optimise patient flows. This study aims to explore patient motives for contacting out-of-hours primary care and the emergency medical services in Denmark. We conducted a cross-sectional observational study by sending a questionnaire to patients contacting out-of-hours primary care and emergency medical services, both of which can be directly contacted by patients, in two of five Danish regions in 2015. As we aimed to focus on the first access point, the emergency department was not included. The questionnaire included items on patient characteristics, health problem and 26 pre-defined motives. Descriptive analyses of patient characteristics and motives were conducted, stratified by the two health care service providers. Factors associated with contacting each of the two service providers were explored in a modified Poisson regression analysis, and adjusted risk ratios were calculated. Three key motives for contacting the two service providers were identified: ‘unpleasant symptoms’, ‘perceived need for prompt action’ and ‘perceived most suitable health care provider’. Other important motives were ‘need arose outside office hours’ and ‘wanted to talk to a physician’ (out-of-hours primary care) and ‘expected need for ambulance’ and ‘worried’ (emergency medical services). Higher probability of contacting the emergency medical services versus out-of-hours primary care was seen for most motives relating to own assessment and expectations, previous experience and knowledge, and own needs and wishes. Lower probability was seen for most motives relating to perceived barriers and benefits. Patient motives for contacting the two health care service providers were partly overlapping. The study contributes with new knowledge on the complex decision-making process of patients in need of acute health care. This knowledge could help optimise existing health care services, such as patient safety and the service level, without increasing health care costs.

中文翻译：

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丹麦从事非工作时间护理的患者动机：一项横断面研究

需要急性医疗保健的患者并不总是与最合适的医疗保健服务提供者联系。与非工作时间联系紧急情况的初级保健可能会延迟护理，而与非紧急问题联系紧急医疗服务可能最终会影响患者的安全。对联系特定医疗保健提供者的患者动机的更多了解可能有助于优化患者流程。这项研究旨在探讨患者在丹麦从事非工作时间的初级保健和紧急医疗服务的动机。我们通过在2015年的五个丹麦地区中的两个地区向非工作时间的初级保健和急诊医疗服务的患者发送问卷来进行横断面观察研究，这两个患者都可以直接与他们联系。专注于第一个接入点 急诊室不包括在内。问卷包括有关患者特征，健康问题和26种预定动机的项目。对患者的特征和动机进行了描述性分析，并由两家医疗服务提供商进行了分层。在改进的Poisson回归分析中探讨了与联系这两个服务提供商的每个人相关的因素，并计算了调整后的风险比。确定了联系这两家服务提供商的三个主要动机：“不愉快的症状”，“认为需要迅速采取行动”和“认为最合适的医疗保健提供商”。其他重要的动机是“需要在办公时间以外出现”，“想要与医生交谈”（非工作时间的初级保健），“预期需要救护车”和“担心”（急诊医疗服务）。出于与自己的评估和期望，先前的经验和知识以及自己的需求和愿望有关的大多数动机，与紧急医疗服务联系的可能性更高。与动机相关的障碍和利益相关的大多数动机认为可能性较低。与两个医疗服务提供者联系的患者动机部分重叠。该研究为需要急诊医疗的患者的复杂决策过程提供了新的知识。这些知识可以帮助优化现有的医疗保健服务，例如患者安全性和服务水平，而不会增加医疗保健成本。以前的经验和知识，以及自己的需求和愿望。与动机相关的障碍和利益相关的大多数动机认为可能性较低。与两个医疗服务提供者联系的患者动机部分重叠。该研究为需要急诊医疗的患者的复杂决策过程提供了新的知识。这些知识可以帮助优化现有的医疗保健服务，例如患者安全性和服务水平，而不会增加医疗保健成本。以前的经验和知识，以及自己的需求和愿望。与动机相关的障碍和利益相关的大多数动机认为可能性较低。与两个医疗服务提供者联系的患者动机部分重叠。该研究为需要急诊医疗的患者的复杂决策过程提供了新的知识。这些知识可以帮助优化现有的医疗保健服务，例如患者安全性和服务水平，而不会增加医疗保健成本。