Outcome of patients who refused out-of-hospital medical assistance
Autor: | Henry C. Thode, Jonathan L. Burstein, Judd E. Hollander, Mark C. Henry, Emt-D David Gentile, Jeanne M. Alicandro |
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Rok vydání: | 1996 |
Předmět: |
Adult
Emergency Medical Services medicine.medical_specialty Adolescent media_common.quotation_subject New York MEDLINE Suburban Health Treatment Refusal Denial Outcome Assessment Health Care Health care Emergency medical services Humans Medicine Mortality Child Aged media_common Aged 80 and over Out of hospital business.industry Infant Newborn Health services research Infant General Medicine Middle Aged Patient Acceptance of Health Care Prognosis medicine.disease Hospitalization Child Preschool Emergency medicine Emergency Medicine Health Services Research Medical emergency business Follow-Up Studies Cohort study |
Zdroj: | The American Journal of Emergency Medicine. 14:23-26 |
ISSN: | 0735-6757 |
DOI: | 10.1016/s0735-6757(96)90007-8 |
Popis: | Activation of the emergency medical services (EMS) system does not always result in transport of a patient to the hospital. This study assessed the outcomes of patients who refused medical assistance in the field, to determine if refusal of medical assistance (RMA) is associated with poor outcomes. Four high-volume suburban volunteer ambulance corps participated in the study. Consecutive patients who refused medical assistance were prospectively enrolled. Medical and identifying data were collected for each patient. Telephone follow-up was conducted to determine the patient's condition and if the patient sought further care after RMA. Primary endpoints were whether the patient sought further care, was admitted to a hospital, or died subsequent to RMA. Follow-up was successfully obtained for 199 of 321 patients enrolled (62%). Of these 199 patients, 95 (48%) sought further medical care within 1 week for the same complaint, with 13 being admitted to the hospital. Six of the 13 admitted patients had chief complaints of a cardiac or respiratory nature. One patient died during hospital admission. Even if none of the patients lost to follow-up had sought further care, a substantial number of patients who refuse out-of-hospital medical assistance seek further care. Some of these patients require hospital admission, especially those with cardiac or respiratory complaints. Efforts to minimize RMA should be especially focused on patients with such complaints. |
Databáze: | OpenAIRE |
Externí odkaz: |
Abstrakt: | Activation of the emergency medical services (EMS) system does not always result in transport of a patient to the hospital. This study assessed the outcomes of patients who refused medical assistance in the field, to determine if refusal of medical assistance (RMA) is associated with poor outcomes. Four high-volume suburban volunteer ambulance corps participated in the study. Consecutive patients who refused medical assistance were prospectively enrolled. Medical and identifying data were collected for each patient. Telephone follow-up was conducted to determine the patient's condition and if the patient sought further care after RMA. Primary endpoints were whether the patient sought further care, was admitted to a hospital, or died subsequent to RMA. Follow-up was successfully obtained for 199 of 321 patients enrolled (62%). Of these 199 patients, 95 (48%) sought further medical care within 1 week for the same complaint, with 13 being admitted to the hospital. Six of the 13 admitted patients had chief complaints of a cardiac or respiratory nature. One patient died during hospital admission. Even if none of the patients lost to follow-up had sought further care, a substantial number of patients who refuse out-of-hospital medical assistance seek further care. Some of these patients require hospital admission, especially those with cardiac or respiratory complaints. Efforts to minimize RMA should be especially focused on patients with such complaints. |
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ISSN: | 07356757 |
DOI: | 10.1016/s0735-6757(96)90007-8 |