Article

Retrospective cohort with linkage of administrative data sets.
OBJECTIVES: To describe the patterns (for example, number of visits by year
post-injury) and characteristics of the emergency department (ED) visits (for
example, acuity level, timing of visits, reasons for visits) made by persons with
traumatic spinal cord injury (TSCI) over a 6-year period following injury.
SETTINGS: Ontario, Canada. METHODS: Rates of ED utilization and reasons for ED
visits were calculated between the fiscal years 2003-2009. Reasons for visits
were categorized by acuity level: potentially preventable visits were defined as
visits related to ambulatory sensitive conditions; low acuity and high acuity
visits were defined by the Canadian Triage and Acuity Scale. RESULTS: The total
number of ED visits for the 6-year period is 4403 (n=1217). Of these visits, 752
(17%) were classified as potentially preventable, 1443 (33%) as low acuity and
2208 (50%) as high acuity. The majority of patients, regardless of acuity level,
did not see a primary care practitioner on the day of the ED visit and most
visits occurred during the weekday (Mon-Fri 0700-1659 hours). ED use was highest
in the first year but remained high over the subsequent years. For potentially
preventable visits, the majority of visits were related to urinary tract
infections (n=385 visits, 51.2%), followed by pneumonia (n=91, 12.1%).
CONCLUSION: Given the high rates of ED use for low acuity and potentially
preventable conditions, these results suggest that the ED is being used as an
inappropriate substitute for primary care for individuals with TSCI 50% of the
time.

Langue : ANGLAIS