Emergency Department Discharge Outcome and Psychiatric Consultation in North African Patients

Bibliographic Data

ID15462001
AuthorsOsnat Keidar (0000-0001-9510-9380, University of Bern, corresponding author), Sabrina Jegerlehner (0000-0002-0868-0608, University of Bern), Sabrina N Jegerlehner (Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland), Stephan Ziegenhorn (0000-0001-8149-5647, University of Bern), Adam D Brown (0000-0003-2191-6061, New School), Martin Müller (0000-0002-5575-442X, University of Bern), Aristomenis K Exadaktylos (0000-0002-2705-5170, University of Bern), David Srivastava (0000-0002-4744-0463, University of Bern), David S Srivastava (Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland)
Year2018
Volume15
Issue9
Pages2033-2033
Publication date2018-09-17
Open AccessYes
TypeARTICLE
VenueInternational Journal of Environmental Research and Public Health (JOURNAL)
Journal identifiersISSN: 1661-7827 • E-ISSN: 1660-4601
PublisherMultidisciplinary Digital Publishing Institute (PUBLISHER • CH)
DOI10.3390/ijerph15092033
PMID30227686
OpenAlexW2889911330
LanguageEN
Citations received1
References cited29

Studies in Europe have found that immigrants, compared to the local population, are more likely to seek out medical care in Emergency Departments (EDs). In addition, studies show that immigrants utilize medical services provided by EDs for less acute issues. Despite these observed differences, little is known about the characteristics of ED use by North African (NA) immigrants. The main objective of this study was to examine whether there were differences in ED discharge outcomes and psychiatric referrals between NA immigrants and Swiss nationals. A retrospective analysis was conducted using patient records from NA and Swiss adults who were admitted to the ED of the University Hospital in Bern (Switzerland) from 2013−2016. Measures included demographic information as well as data on types of admission. Outcome variables included discharge type and psychiatric referral. A total of 77,619 patients generated 116,859 consultations to the ED, of which 1.1 per cent ( n = 1338) were consultations by NA patients. Compared to Swiss national patients, NA patients were younger, with a median age of 38.0 (IQR 28−51 years vs. 52.0 (IQR 32−52) for Swiss and predominantly male (74.4% vs. 55.6% in the Swiss). NA patient admission type was more likely to be "walk-in" or legal admission (7.5% vs 0.8 in Swiss,). Logistic regressions indicated that NA patients had 1.2 times higher odds (95% CI 1.07−1.40, p < 0.003) of receiving ambulatory care. An effect modification by age group and sex was observed for the primary outcome "seen by a psychiatrist", especially for men in the 16−25 years age group, whereby male NA patients had 3.45 times higher odds (95% CI: 2.22−5.38) of having being seen by a psychiatrist. In conclusion differences were observed between NA and Swiss national patients in ED consultations referrals and outcomes, in which NA had more ambulatory discharges and NA males, especially young, were more likely to have been seen by psychiatrist. Future studies would benefit from identifying those factors underlying these differences in ED utilization

Ambulatory · Emergency department · Family medicine · Immigration · Logistic regression · Medical record · Odds · Odds ratio · Population · Psychiatry · Referral · Retrospective cohort study · Demography · Emergency and Acute Care Studies · Interpreting and Communication in Healthcare · Medicine · Migration, Health and Trauma · Emergency Medicine · Internal Medicine · Pediatrics

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