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Master Thesis

Influence de l’urgence ressentie dans l’orientation vers une consultation aux urgences sur le Bassin d’Arcachon

Abstract : Introduction: emergency can be defined as "any circumstance that suggests a functional or vital risk if medical action is not taken immediately" but also as a phenomenon occurring suddenly and unexpectedly that surprises and worries the patient. The number of visits to the emergency department is constantly increasing, leading to a stigmatization of the patient, some of whose recourse is described as inappropriate. The objective of this work is to describe the characteristics of patients who consult the emergency department spontaneously and to evaluate the relationship between the urgency felt by the patient and the decision to consult the emergency department. Methods: monocentric prospective observational study including adult patients who consulted spontaneously in the emergency department of the Arcachon health centre between 15/08/2018 and 07/09/2018. A qualitative study was carried out beforehand in order to create a questionnaire and a scale of perceived urgency, varying from 1 to 5, to be filled in by the patient. Results: for the qualitative study, 21 interviews of patients were collected and 57% of them considered that their reason for consultation represents a danger. In the quantitative study, 482 patients were included. The average age was 47 years, with 56% women and 44% men. The majority of patients reside in the region (61%). 196 (41%) patients have a perceived degree of urgency of 3. High age, female sex, pain, time to onset of symptoms, prior medical information, and a hypothesis of diagnosis are factors influencing the perceived urgency in a statistically significant way (p<0.005). Although the perceived urgency is important in our study, 85% of patients felt that their reason for consultation could be managed by their general practitioner. Conclusion: the urgency felt by the patient is a major factor in his decision of where to consult in primary care. This feeling is subjective and influenced by other factors. It appears that the motivations of patients consulting emergency departments are sometimes the result of a lack of knowledge of the health care system, but also of a difficulty in accessing care within a time frame compatible with the perceived urgency.
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Master Thesis
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Submitted on : Friday, October 9, 2020 - 2:53:10 PM
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  • HAL Id : dumas-02962797, version 1


Jonathan Munos. Influence de l’urgence ressentie dans l’orientation vers une consultation aux urgences sur le Bassin d’Arcachon. Médecine humaine et pathologie. 2020. ⟨dumas-02962797⟩



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