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Barriers and Facilitators to High Emergency Department Use Among Patients with Mental Disorders: A Qualitative Investigation.
Fleury, Marie-Josée; Imboua, Armelle; Grenier, Guy.
Afiliación
  • Fleury MJ; Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, QC, H3A 1A1, Canada. flemar@douglas.mcgill.ca.
  • Imboua A; Douglas Hospital Research Centre, 6875 LaSalle Blvd, Montreal, QC, H4H 1R3, Canada. flemar@douglas.mcgill.ca.
  • Grenier G; Douglas Hospital Research Centre, 6875 LaSalle Blvd, Montreal, QC, H4H 1R3, Canada.
Community Ment Health J ; 60(5): 869-884, 2024 Jul.
Article en En | MEDLINE | ID: mdl-38383882
ABSTRACT
This qualitative study explored reasons for high emergency department (ED) use (3 + visits/year) among 299 patients with mental disorders (MD) recruited in four ED in Quebec, Canada. A conceptual framework including healthcare system and ED organizational features, patient profiles, and professional practice guided the content analysis. Results highlighted insufficient access to and inadequacy of outpatient care. While some patients were quite satisfied with ED care, most criticized the lack of referrals or follow-up care. Patient profiles justifying high ED use were strongly associated with health and social issues perceived as needing immediate care. The main barriers in professional practice involved lack of MD expertise among primary care clinicians, and insufficient follow-up by psychiatrists in response to patient needs. Collaboration with outpatient care may be prioritized to reduce high ED use and improve ED interventions by strengthening the discharge process, and increasing access to outpatient care.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Investigación Cualitativa / Servicio de Urgencia en Hospital / Accesibilidad a los Servicios de Salud / Trastornos Mentales Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Community Ment Health J Año: 2024 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Investigación Cualitativa / Servicio de Urgencia en Hospital / Accesibilidad a los Servicios de Salud / Trastornos Mentales Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Community Ment Health J Año: 2024 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos