Analysis of effectiveness and safety of a three-part triage system for the access to dermatology specialist health care.
Identifieur interne : 000847 ( Ncbi/Merge ); précédent : 000846; suivant : 000848Analysis of effectiveness and safety of a three-part triage system for the access to dermatology specialist health care.
Auteurs : J. Deluca [Italie] ; A. Goldschmidt [Allemagne] ; K. Eisendle [Italie]Source :
- Journal of the European Academy of Dermatology and Venereology : JEADV [ 1468-3083 ] ; 2016.
Abstract
Accessibility and waiting times pose a general problem in public financed health care systems. In Italy a three-part triage system (urgent, priority and deferrable with a corresponding maximum time target before treatment of 1, 8 and 60 days respectively) to gain faster treatment for urgent and emergent cases of dermatology outpatients has been introduced.
DOI: 10.1111/jdv.13295
PubMed: 26448132
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Deluca</name><affiliation wicri:level="1"><nlm:affiliation>Department of Dermatology, Venereology and Allergology, Academic Teaching Department of Innsbruck Medical University, Central Hospital, Bolzano, Bolzano/Bozen, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Dermatology, Venereology and Allergology, Academic Teaching Department of Innsbruck Medical University, Central Hospital, Bolzano, Bolzano/Bozen</wicri:regionArea><wicri:noRegion>Bolzano/Bozen</wicri:noRegion></affiliation></author><author><name sortKey="Goldschmidt, A" sort="Goldschmidt, A" uniqKey="Goldschmidt A" first="A" last="Goldschmidt">A. Goldschmidt</name><affiliation wicri:level="1"><nlm:affiliation>International Health Care Management Institute, University Trier, Trier, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>International Health Care Management Institute, University Trier, Trier</wicri:regionArea><wicri:noRegion>Trier</wicri:noRegion><wicri:noRegion>Trier</wicri:noRegion><wicri:noRegion>Trier</wicri:noRegion></affiliation></author><author><name sortKey="Eisendle, K" sort="Eisendle, K" uniqKey="Eisendle K" first="K" last="Eisendle">K. Eisendle</name><affiliation wicri:level="1"><nlm:affiliation>Department of Dermatology, Venereology and Allergology, Academic Teaching Department of Innsbruck Medical University, Central Hospital, Bolzano, Bolzano/Bozen, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Dermatology, Venereology and Allergology, Academic Teaching Department of Innsbruck Medical University, Central Hospital, Bolzano, Bolzano/Bozen</wicri:regionArea><wicri:noRegion>Bolzano/Bozen</wicri:noRegion></affiliation></author></analytic><series><title level="j">Journal of the European Academy of Dermatology and Venereology : JEADV</title><idno type="eISSN">1468-3083</idno><imprint><date when="2016" type="published">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Accessibility and waiting times pose a general problem in public financed health care systems. In Italy a three-part triage system (urgent, priority and deferrable with a corresponding maximum time target before treatment of 1, 8 and 60 days respectively) to gain faster treatment for urgent and emergent cases of dermatology outpatients has been introduced.</div></front></TEI><pubmed><MedlineCitation Status="In-Process" Owner="NLM"><PMID Version="1">26448132</PMID><DateCreated><Year>2016</Year><Month>06</Month><Day>22</Day></DateCreated><DateRevised><Year>2016</Year><Month>12</Month><Day>19</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1468-3083</ISSN><JournalIssue CitedMedium="Internet"><Volume>30</Volume><Issue>7</Issue><PubDate><Year>2016</Year><Month>Jul</Month></PubDate></JournalIssue><Title>Journal of the European Academy of Dermatology and Venereology : JEADV</Title><ISOAbbreviation>J Eur Acad Dermatol Venereol</ISOAbbreviation></Journal><ArticleTitle>Analysis of effectiveness and safety of a three-part triage system for the access to dermatology specialist health care.</ArticleTitle><Pagination><MedlinePgn>1190-4</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1111/jdv.13295</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Accessibility and waiting times pose a general problem in public financed health care systems. In Italy a three-part triage system (urgent, priority and deferrable with a corresponding maximum time target before treatment of 1, 8 and 60 days respectively) to gain faster treatment for urgent and emergent cases of dermatology outpatients has been introduced.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">From February 2011 to August 2013, samples of 1526 outpatient electronic medical record cases were randomly retrieved. Diagnoses with their corresponding triage codes were recorded. Urgent visits were further analysed according to the referring physician. The appropriateness of the referral was based on the published state law diagnostic guidelines. Data were statistically analysed using the 2-tailed Pearson chi-squared test or the Fisher exact test.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Overall, 56.5% retrieved cases were deferrable, 13.1% priority and 30.4% urgent. Frequency of diagnoses differed significantly between the three groups (P < 0.05). Appropriateness of the triage level was higher for priority than for urgent referrals (P < 0.05%). An overestimation of urgency levels was noted and urgent cases were not overseen. Triage levels were best assessed by general practitioners (75% correct allocations) followed by emergency physicians (59%) and other specialists (45%) (P < 0.01%).</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">The triage system according to clinical need is safe. Correct allocation according to urgency occurs in <75% and leaves space for improvement. General Practitioners address patient's access significantly better than other physicians, therefore are best suited to function as gatekeepers to the access of specialist care in public funded health care systems.</AbstractText><CopyrightInformation>© 2015 European Academy of Dermatology and Venereology.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Deluca</LastName><ForeName>J</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Department of Dermatology, Venereology and Allergology, Academic Teaching Department of Innsbruck Medical University, Central Hospital, Bolzano, Bolzano/Bozen, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Goldschmidt</LastName><ForeName>A</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>International Health Care Management Institute, University Trier, Trier, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Eisendle</LastName><ForeName>K</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Department of Dermatology, Venereology and Allergology, Academic Teaching Department of Innsbruck Medical University, Central Hospital, Bolzano, Bolzano/Bozen, Italy.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2015</Year><Month>10</Month><Day>07</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>J Eur Acad Dermatol Venereol</MedlineTA><NlmUniqueID>9216037</NlmUniqueID><ISSNLinking>0926-9959</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2015</Year><Month>02</Month><Day>12</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2015</Year><Month>05</Month><Day>18</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2015</Year><Month>10</Month><Day>9</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2015</Year><Month>10</Month><Day>9</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2015</Year><Month>10</Month><Day>9</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">26448132</ArticleId><ArticleId IdType="doi">10.1111/jdv.13295</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Allemagne</li><li>Italie</li></country></list><tree><country name="Italie"><noRegion><name sortKey="Deluca, J" sort="Deluca, J" uniqKey="Deluca J" first="J" last="Deluca">J. Deluca</name></noRegion><name sortKey="Eisendle, K" sort="Eisendle, K" uniqKey="Eisendle K" first="K" last="Eisendle">K. Eisendle</name></country><country name="Allemagne"><noRegion><name sortKey="Goldschmidt, A" sort="Goldschmidt, A" uniqKey="Goldschmidt A" first="A" last="Goldschmidt">A. Goldschmidt</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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