Evidence map›Paper›PMID 34172545›Full record

ArticleBMJ open2021

Qualitative evaluation of primary care providers' experiences caring for frequent users of the emergency department.

Laureline Brunner, Marina Canepa Allen, Mary Malebranche, Catherine Hudon, Nicolas Senn, Olivier Hugli, Francis Vu, Christina Akré, Patrick Bodenmann

Abstract read
In one paragraph

Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Laureline BrunnerDepartment of Vulnerabilities and Social Medicine, Unisanté, Lausanne, Vaud, Switzerland laureline.brunner@unil.ch.ORCID 0000-0003-0397-7696
Marina Canepa AllenDepartment of Vulnerabilities and Social Medicine, Unisanté, Lausanne, Vaud, Switzerland.
Mary MalebrancheDepartment of Medicine, University of Calgary Faculty of Medicine, Calgary, Alberta, Canada.
Catherine HudonFamily Medicine and Emergency Medicine Department, Université de Sherbrooke, Sherbrooke, Quebec, Canada.ORCID 0000-0001-6140-9916
Nicolas SennDepartment of Family Medicine, Unisanté, Lausanne, Vaud, Switzerland.
Olivier HugliEmergency Department, University Hospital of Lausanne, Lausanne, Vaud, Switzerland.ORCID 0000-0003-2312-1625
Francis VuDepartment of Vulnerabilities and Social Medicine, Unisanté, Lausanne, Vaud, Switzerland.
Christina Akré *Department of Epidemiology and Health Systems-University of Lausanne, Unisanté, Lausanne, Vaud, Switzerland.
Patrick Bodenmann *Department of Vulnerabilities and Social Medicine, Unisanté, Lausanne, Vaud, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesMany interventions have been developed over the years to offer frequent users of the emergency department (FUEDs) better access to quality coordinated healthcare. Despite recognising the role primary care physicians (PCPs) play in FUEDs' care, to date their perceptions of case management, the most studied intervention, have rarely been assessed. Furthermore, a gap regarding PCPs' experience of caring for FUEDs persists. Thus, this study aimed to explore PCPs' perceptions of the care provided to FUEDs in emergency and primary care settings, their views on the local case management team (CMT), and their suggestions to improve FUEDs' care.

designQualitative study using in-depth semistructured interviews and inductive thematic analysis.

settingCanton of Vaud, Switzerland.

participantsThirty PCPs participated, 16 in private practice (PP-PCPs) and 14 based at the Lausanne University Centre of General Medicine and Public Health (Unisanté-U-PCPs).

resultsU-PCPs and PP-PCPs thought that most FUEDs' emergency department (ED) visits were legitimate, but questioned ED adequacy to meet FUEDs' needs. Yet, both PCP groups reported encountering many challenges in FUEDs' care themselves. In this context, PP-PCPs seemed more satisfied of the care they provided to FUEDs than U-PCPs. Generally, U-PCPs seemed to find more value in the CMT to help them care for FUEDs than PP-PCPs. To enhance FUEDs' care, U-PCPs and PP-PCPs suggested enhancing collaboration with other healthcare providers. U-PCPs also wished to increase their availability, and some PP-PCPs considered outpatient clinics, larger group practices or medical centres most appropriate to handle FUEDs' needs.

conclusionsThis study highlights the many challenges PCPs face in caring for FUEDs, that a CM intervention has the potential to mitigate, and provides ways forward in improving FUEDs' care, including reinforced communication with the CMT and ED physicians, and structural changes to their own way of delivering care to FUEDs.

Indexed as

Physicians, Primary CareAttitude of Health PersonnelEmergency Service, HospitalHumansPrimary Health CareQualitative ResearchSwitzerlandgeneral medicine (see internal medicine)primary carequalitative research

Identifiers

PMID34172545
PMCPMC8237725

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.