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Record W2061441479 · doi:10.1111/acem.12063

A Regional Survey to Determine Factors Influencing Patient Choices in Selecting a Particular Emergency Department for Care

2013· article· en· W2061441479 on OpenAlexaffabout
Eric Grafstein, Danielle Wilson, Rob Stenstrom, Catherine Jones, Margreth Tolson, Iraj Poureslami, Frank Scheuermeyer

Bibliographic record

VenueAcademic Emergency Medicine · 2013
Typearticle
Languageen
FieldMedicine
TopicEmergency and Acute Care Studies
Canadian institutionsSt. Paul's HospitalUniversity of British Columbia
Fundersnot available
KeywordsMedicineEmergency departmentTriageConfidence intervalOdds ratioAmbulatoryLogistic regressionCross-sectional studyOddsFamily medicineEmergency medicineNursingInternal medicine

Abstract

fetched live from OpenAlex

OBJECTIVES: Increases in regional emergency department (ED) efficiencies might be obtained by shifting patients to less crowded EDs. The authors sought to determine factors associated with a patient's decision to choose a specific regional ED. Based on prior focus group discussions with volunteers, the hypothesis was that distance to a specific ED and perceived ED wait times would be important. METHODS: A cross-sectional survey was developed using qualitative focus group methodology. The resulting survey was composed of 17 questions relating to patient decisions in choosing a specific ED and was administered in each of six EDs in a single urban Canadian health region at all hours of the day. Ambulatory patients with a Canadian Triage and Acuity Scale (CTAS) level 3 to 5 and aged ≥19 years were surveyed. The primary outcome was the proportion of patients whose main motivation for attending a specific ED was either distance traveled to reach the ED or perceived ED waiting time. Multivariable logistic regression was performed to assess factors influencing both of these reasons. RESULTS: A total of 757 patients were approached and 634 surveys (83.8%) were completed. Distance from the ED (named by 44.0% of respondents as their primary reason) and perceived ED wait times (9.3%) were the main motivations for patients to attend a specific ED. Multivariable analysis of factors associated with choosing distance revealed that ED distance < 10 km (adjusted odds ratio [OR] = 2.20, 95% confidence interval [CI] = 1.45 to 3.33; p = 0.001) and age ≥ 60 years (adjusted OR = 1.58, 95% CI = 1.12 to 2.26; p = 0.04) were significant in choosing a particular ED. Multivariable analysis of factors influencing wait times demonstrated that having a painful complaint (adjusted OR = 1.42, 95% CI = 1.05 to 1.98; p = 0.047) and age < 60 years (OR = 1.47, 95% CI = 1.02 to 2.14; p = 0.049) were significant in choosing a particular ED. CONCLUSIONS: In a multicenter survey of patients from an urban health region, distance to a specific ED and perceived ED wait times were the most important reasons for choosing that ED. Younger patients and those with painful conditions appear to place greater priority on wait times.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.003
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow), Insufficient payload (model declined to judge)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.035
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0010.003
Meta-epidemiology (narrow)0.0010.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0000.001
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0010.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.068
GPT teacher head0.354
Teacher spread0.285 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations30
Published2013
Admission routes2
Has abstractyes

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