Click here to download

The "improper" access to the emergency department: the influence of some individual factors
Journal Title: RICERCHE DI PSICOLOGIA  
Author/s: Paola Iannello, Anna Mottini 
Year:  2014 Issue: 2 Language: Italian 
Pages:  15 Pg. 325-339 FullText PDF:  217 KB
DOI:  10.3280/RIP2014-002009
(DOI is like a bar code for intellectual property: to have more infomation:  clicca qui   and here 


In recent years, in Italy the overcrowding of the emergency departments (ED), closely linked to the phenomenon of the improper accesses, is experiencing a gradual and steady increase, with negative consequences for both the users and the operators. The present study aims to investigate the influence of some individual variables on the decision to go to the PS without a real emergency. In particular, through self-report questionnaires, socio-demographic factors, specific personality characteristics, the individual level of health literacy and trust in respect of the general practitioner. The sample consists of 198 participants aged between 23 and 89 years. The results show that different sets of factors, such as age, the level of anxiety, the need for cognitive closure and the health knowledge actually possessed by the participants, affect significantly on how to access the PS. In particular, it emerges that older people use the PS in a more appropriate way than younger people; in addition, a good level of health knowledge, a low level of anxiety and a low need for cognitive closure are associated with a significantly more appropriate mode of access to the PS.
Keywords: Health Literacy, Personality, Elderly, Access to Emergency Department.

  1. Aminzadeh, F., & Dalziel, W.B. (2002). Older adults in the emergency department: a systematic review of pattern of use, adverse outcomes, and effectiveness of interventions. Annals of Emergency Medicine, 39, 238-47., DOI: 10.1067/mem.2002.121523
  2. Baker, D.W. (2006). The meaning and the measure of health literacy. Journal of General Internal Medicine, 21(8), 878-883., DOI: 10.1111/j.1525-1497.2006.00540.x
  3. Becchi, M.A., Bellelli, F., Clarizio, M., & Carulli, N.(2005). Caratteristiche dei pazienti ricoverati in un reparto per acuti di medicina interna. È l’ospedale il luogo piu idoneo di cura? Annali Italiani Medicina Interna, 20, 233-44.
  4. Bellentani, M., Catania, S., Bugliari Armenio, L., & Damiani, G. (2013). Assistenza h24, Cure primarie e riduzione degli accessi impropri al Pronto soccorso. Monitoraggio di progetti regionali dal Ministero della Salute su obiettivi prioritari di Psn 2009. Quaderno di Monitor, 11, 34-8.
  5. Belleri, G. (2006). L’urgenza differibile è quella degli altri. Occhio clinico, 9, 30-5.
  6. Bianco, A., Pileggi, C., & Angelillo, I.F. (2003). Non-urgent visits to a hospital emergency department in Italy. Public Health, 117, 250-5., DOI: 10.1016/S0033-3506(03)00069-6
  7. Bissoni G., & Moirano F.(2013). Editoriale. Quaderno di Monitor, 11, 5-8.
  8. Chalfin, D.B., Trzeciak, S., Likourezos, A., Baumann, B.M., & Dellinger, R.P. (2007). Impact of Delayed Transfer of Critically Ill Patients from the Emergency Department of the Intensive Care Unit. Critical Care Medicine, 35, 1477-1483., DOI: 10.1097/01.CCM.0000266585.74905.5A
  9. Chew, L.D., Bradley, K.A., & Boyko, E.J. (2004). Brief questions to identify patients with inadequate health literacy. Family Medicine, 36(8), 588-594 .
  10. Damiani, G., Silvestrini, G., Vena, V., & Ricciardi, W. (2013) Indagine sui determinanti organizzativi e professionalicaratterizzanti i progetti Regionali. Quaderno di Monitor, 11, 39- 50.
  11. Di Tommaso, F., Falasca, P., Calderone, B., Nicoli, A., Berardo, A., & Rossi, A. (2010). Analisi dei fattori psico-sociali e sanitari che hanno indotto i cittadini all’uso non appropriato del Pronto soccorso nella Ausl di Ravenna nel 2008, Notiziario Istituto Superiore Sanità, 23(2), iii-iv.
  12. Donatini, A. (2013). Casi studio. Esperienze regionali per la riduzione degli accessi al Pronto soccorso. Quaderni di Monitor, 11, 51-65. Iannello, P., & Mottini, A. (2014). Why do people go to the emergency department: psychological determinants. International Workshop “Right patient, right place, right time. When and how to use the Emergency Department: Health literacy, decision-making and communication”. Milano, 11-12 aprile.
  13. Kirsch, I., Jungeblut, A., Jenkins, L. & Kolstad, A. (1993) Adult literacy In America. A First Look at the Results of the National Adult Literacy Survey. National Centre for Education Statistics, US Departmant of Education, Washington DC, USA.
  14. Lo Monaco, N. (2001). Progetto N. 3-Azienda ULSS 10, Presidi Ospedalieri di S. Dona di Piave, Portogruaro, Jesolo. In Report finale della sperimentazione nazionale. Concettualizzazione, sviluppo e valutazione di strumenti di osservazione e di intervento che aumentino l’uso appropriato dell’ospedale per acuti, 44–54.
  15. McCusker, J., Roberge, D., Lévesque, J.F., Ciampi, A., Vedeboncoer, A., Larouche, D., & Sanche, S. (2010). Emergency Department visits and primary care among adults with chronic conditions. Medical Care, 48(11), 972-80., DOI: 10.1097/MLR.0b013e3181eaf86d
  16. Miro, O., Sanchez, M. & Milla., J. (2000) Hospital mortality and staff workload (letter). Lancet, 356, 1356-1357., DOI: 10.1016/S0140-6736(05)74269-0
  17. Moll van Charante, E.P., ter Riet, G., & Bindels, P.J.E. (2008). Self-referrals to the A&E department during out-of-hours: patients’motive and characteristics. Patient Education and Counselling, 70, 256-65.
  18. , DOI: 10.1016/j.pec.2007.10.012
  19. Mussi, C., Pinelli, G, & Annoni, G. (2008). L’anziano e il Pronto Soccorso: il Triage Elderly and emergency department: the Triage. Giornale di Gerontologia, 56, 109-117.
  20. Nati, G., Ialongo, A., Fucito, G., D’Angelo, E., De Lucia, L., Valente, F., Chiriatti, A., Solero, F., & Morosetti, M. (2010). Il management dei codici bianchi e verdi da parte dei medici di medicina generale in un Pronto Soccorso di Roma: lo studio MAPS. Rivi sta Società Italiana Medicina Generale, 3, 18-22.
  21. Panuccio, A. (2009). Sistema di emergenza-urgenza: appropriatezza nell’utilizzo dei servizi di primo contatto. Quaderni di Monitor, 11, 24-27.
  22. Pedrabissi, L., & Santinello, M. (1989). Inventario per l’ansia di stato e di tratto (forma y). Firenze: Organizzazioni Speciali.
  23. Pierro, A., Mannetti, L., Converso, D, Garsia, V.,Miglietta, A., Ravenna, M., & Rubini, M. (1995). Caratteristiche strutturali della versione italiana della scala di bisogno di chiusura cognitiva. TPM - Testing, Psicometria, Metodologiai, 125-141.
  24. Pines, J.M., & Heckman, J.D. (2009). Emergency department boarding and profit maximization for high-capacity hospitals: challenging conventional wisdom. Annals of Emergency Medicine, 53, 256-8.
  25. 10.1016/j.annemergmed.2008.08.012.
  26. Pitts, S.R., Niska, R.W., Xu J, & Burt, C.W. (2008). National Hospital Ambulatory Medical Care Survey: 2006 emergency department summary. National
  27. Health Statistics Reports, 7, 1-38. Rastelli, G., Cavazza, M., & Cervellin, G. (2010). Overcrowded ERs: analysis of the phenomenon and managing proposals. Emergency Care Journal, 2, 25-35., DOI: 10.4081/ecj.2010.2.25
  28. Ratzan, S.C., & Parker, R.M. (2000). Introduction. In C.R. Selden, M. Zorn, S.C.
  29. Ratzan & R.M. Parker (Eds.), National Library of Medicine Current Bibliographies in Medicine: Health Literacy. NLM Pub. No. CBM 2000-1. Bethesda, MD: National Institutes of Health, U.S. Department of Health and Human Services.
  30. Salvi, F., Grilli, A., Morichi, V., Lucarelli, M., Macchiati, I., Marotti, E., Lattanzio, F., & De Tommaso, G. (2011). L’anziano in Pronto Soccorso: problemi, evidenze scientifiche e nuovi modelli di assistenza. The elderly in the Emergency Department: problems, evidence and new models of care. Giornale di Gerontologia, 59, 179-186.
  31. Santoro, E. (2009). Web 2.0 e medicina. Roma: Il Pensiero Scientifico Editore.
  32. Saugo, M., Mantoan, D., Toffanin, R., Rubin, R., & Pellizzari, M. (2008). Accessi al Pronto soccorso: Ruolo delle pratiche di Medicina generale singole e associate dell’Azienda ULSS “Alto Vicentino”. Bollettino informativo del Sistema Epidemiologico Regionale del Veneto, 2, 7-8.
  33. Spielberger, C.D., Gorsuch, R.L., Lushene, R., Vagg, P.R., & Jacobs, G.A. (1983). Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press.
  34. Webster, D.M., & Kruglanski, A.W. (1994). Individual Differences in Need for Cognitive Closure. Journal of Personality and Social Psychology, 67(6), 1049-1062.

Paola Iannello, Anna Mottini, The "improper" access to the emergency department: the influence of some individual factors in "RICERCHE DI PSICOLOGIA " 2/2014, pp. 325-339, DOI:10.3280/RIP2014-002009

   

FrancoAngeli is a member of Publishers International Linking Association a not for profit orgasnization wich runs the CrossRef service, enabing links to and from online scholarly content