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Background <p>The high utilization of emergency departments (ED) in Germany has been discussed for years. A&#xa0;significant portion are self-referred patients and patients admitted by the emergency medical services, often with less urgent care needs. For this reason, the reform of emergency care is aiming for early telephone and digital assessment and management of patients at suitable care levels. This requires an in-depth understanding of patients’ motives and needs, which is the aim of this study.</p> Methods <p>Data collection was carried out as an anonymized tablet-based questionnaire survey. The survey was conducted from March–April 2024 in five Berlin EDs. The questionnaire covered topics such as sociodemographic factors, complaints, access routes and consultation motives. Unaccompanied minors, emergencies, persons unable to give consent or patients lacking sufficient German language skills were excluded. The Spearman’s rho test was used for correlations of ordinal variables.</p> Results <p>During the study period, 13,701 patients visited the participating EDs; of these, 4347 were invited to participate in the survey, with 2512 patients taking part (consent rate: 57.8%). The sample included various age groups and educational levels. Approximately one-third of respondents had a&#xa0;migration background (29.7%), and more than two-thirds (71.3%) subjectively rated their complaints as very urgent/urgent. Most patients stated that they visited the ED due to the severity of their symptoms (51.8%), health-related anxiety (23.9%), or inadequate accessibility of outpatient care (21.8%). Almost half of the patients had made contact to ambulatory care prior to presenting to the ED. About two thirds (68.3%) of the interviewees knew the 24/7&#xa0;service number 116117 for nonemergency care. Roughly one third said they would be open to using a&#xa0;symptom checker, and a&#xa0;vast majority of 89.3% would accept an appointment at a&#xa0;physician practice instead of presenting at the ED.</p> Conclusion <p>The results point to the fact that patients seeking care in EDs are in search of a&#xa0;rapid assessment of mostly ill-defined medical needs. Although a&#xa0;relevant portion of those patients had prior contact to a&#xa0;physician practice or an out-of-hours service, many report that ambulatory care had not been sufficiently easy to access. It remains unclear why the increased awareness of the service number for acute but nonemergent medical needs (116117) among patients in the EDs has not had a&#xa0;greater effect in preventing ED utilization.</p>

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Inanspruchnahme von Berliner Notaufnahmen

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年8月11日

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  • Kalina Witt,
  • Sarah Oslislo,
  • Ulrike von Arnim,
  • Philipp Kellner,
  • Katja Trommler,
  • Sebastian Karmann,
  • Johannes Hagelskamp,
  • Christian Wrede,
  • Rajan Somasundaram,
  • Dominik von Stillfried

摘要

Background

The high utilization of emergency departments (ED) in Germany has been discussed for years. A significant portion are self-referred patients and patients admitted by the emergency medical services, often with less urgent care needs. For this reason, the reform of emergency care is aiming for early telephone and digital assessment and management of patients at suitable care levels. This requires an in-depth understanding of patients’ motives and needs, which is the aim of this study.

Methods

Data collection was carried out as an anonymized tablet-based questionnaire survey. The survey was conducted from March–April 2024 in five Berlin EDs. The questionnaire covered topics such as sociodemographic factors, complaints, access routes and consultation motives. Unaccompanied minors, emergencies, persons unable to give consent or patients lacking sufficient German language skills were excluded. The Spearman’s rho test was used for correlations of ordinal variables.

Results

During the study period, 13,701 patients visited the participating EDs; of these, 4347 were invited to participate in the survey, with 2512 patients taking part (consent rate: 57.8%). The sample included various age groups and educational levels. Approximately one-third of respondents had a migration background (29.7%), and more than two-thirds (71.3%) subjectively rated their complaints as very urgent/urgent. Most patients stated that they visited the ED due to the severity of their symptoms (51.8%), health-related anxiety (23.9%), or inadequate accessibility of outpatient care (21.8%). Almost half of the patients had made contact to ambulatory care prior to presenting to the ED. About two thirds (68.3%) of the interviewees knew the 24/7 service number 116117 for nonemergency care. Roughly one third said they would be open to using a symptom checker, and a vast majority of 89.3% would accept an appointment at a physician practice instead of presenting at the ED.

Conclusion

The results point to the fact that patients seeking care in EDs are in search of a rapid assessment of mostly ill-defined medical needs. Although a relevant portion of those patients had prior contact to a physician practice or an out-of-hours service, many report that ambulatory care had not been sufficiently easy to access. It remains unclear why the increased awareness of the service number for acute but nonemergent medical needs (116117) among patients in the EDs has not had a greater effect in preventing ED utilization.