Ambulance use for ‘primary care’ problems ::an ethnographic study of seeking and providing help in a UK ambulance service
| Autor: | Alison Shaw, Rebecca K Barnes, Sarah Purdy, Matthew J Booker |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Typology
Adult Male medicine.medical_specialty Emergency Medical Services Adolescent Ambulances urgent care Qualitative property Centre for Academic Primary Care 03 medical and health sciences Young Adult 0302 clinical medicine Health care Emergency medical services Medicine Humans ambulance 030212 general & internal medicine Anthropology Cultural Original Research Aged Receipt Aged 80 and over Primary Health Care business.industry 030503 health policy & services Public health Telephone call General Medicine emergency medical services decision-making Middle Aged Patient Acceptance of Health Care medicine.disease United Kingdom Socioeconomic Factors Candidacy Emergency Medicine Female primary care sensitive conditions Medical emergency 0305 other medical science business |
| Zdroj: | Booker, M J, Purdy, S, Barnes, R & Shaw, A R G 2019, ' Ambulance use for ‘primary care’ problems : an ethnographic study of seeking and providing help in a UK ambulance service ', BMJ Open, vol. 9, no. 10, e033037 . https://doi.org/10.1136/bmjopen-2019-033037 BMJ Open |
| DOI: | 10.1136/bmjopen-2019-033037 |
| Popis: | ObjectivesTo explore what factors shape a service user’s decision to call an emergency ambulance for a ‘primary care sensitive’ condition (PCSC), including contextual factors. Additionally, to understand the function and purpose of ambulance care from the perspective of service users, and the role health professionals may play in influencing demand for ambulances in PCSCs.DesignAn ethnographic study set in one UK ambulance service. Patient cases were recruited upon receipt of ambulance treatment for a situation potentially manageable in primary care, as determined by a primary care clinician accompanying emergency medical services (EMS) crews. Methods used included: structured observations of treatment episodes; in-depth interviews with patients, relatives and carers and their GPs; purposeful conversations with ambulance clinicians; analysis of routine healthcare records; analysis of the original EMS ‘emergency’ telephone call recording.ResultsWe analysed 170 qualitative data items across 50 cases. Three cross-cutting concepts emerged as central to EMS use for a PCSC: (1) There exists a typology of nine ‘triggers’, which we categorise as either ‘internal’ or ‘external’, depending on how much control the caller feels they have of the situation; (2) Calling an ambulance on behalf of someone else creates a specific anxiety about urgency; (3) Healthcare professionals experience conflict around fuelling demand for ambulances.ConclusionsPrevious work suggests a range of sociodemographic factors that may be associated with choosing ambulance care in preference to alternatives. Building on established sociological models, this work helps understand how candidacy is displayed during the negotiation of eligibility for ambulance care. Seeking urgent assistance on behalf of another often requires specific support and different strategies. Use of EMS for such problems—although inefficient—is often conceptualised as ‘rational’ by service users. Public health strategies that seek to advise the public about appropriate use of EMS need to consider how individuals conceptualise an ‘emergency’ situation. |
| Databáze: | OpenAIRE |
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