Messung des Gesundheitszustands anhand Charts - Lebensqualität von Patienten im ärztlichen Notfalldienst

Zusammenfassung

Über die Lebensqualität von Patienten, die außerhalb der normalen Sprechstundenzeit den ärztlichen Notdienst aufsuchen, ist wenig bekannt. Ziel einer Untersuchung war die Ermittlung des funktionellen Gesundheitszustands in Abhängigkeit von der Inanspruchnahmezeit, der Beschwerden, Diagnosen und ärztlichen Leistungen, des Krankheitsschweregrads und der Dringlichkeit der Behandlung sowie des Verlaufs. Die gesundheitsbezogene Lebensqualität kann schnell, reliabel und gut mit den so genannten Wonca-Charts-plus-2 gemessen werden. Die hier gemessenen Werte liegen deutlich außerhalb des Bereichs, der von normalen Kontrollpersonen erreicht wird. Die Diskussion um eine inadäquate Inanspruchnahme des ärztlichen Notdienstes greift ohne Berücksichtigung der Lebensqualität und der Behandlungszufriedenheit der Patienten ins Leere.

Summary

Little is known about health related quality of life of patients seeking urgent medical care. The aim of this study was [1] to describe the episodes of care using the ICPC classification and [2] to relate these data to the functional status measured by the 6 Wonca-COOP-Charts and two optional charts for main and the main complaint chart. 256 patients seeking medical care to a community based emergency service during 11 weekends. The most common reasons for encounter were fever, sore throat, abdominal pain and shortness of breath. The functional status of these patients was moderately to severely impaired and related both to the severity and urgency of the health problem and to the process of care (need for thorough examination by the physician, home visits, hospital admission). In conclusion the study supports that the usage of the Wonca-COOP-Charts in the assessment of quality of emergency care. The discussion about appropriateness of emergency services - which hitherto is based only on doctors appraisal of health status - needs supplementation with the patients point of view.

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Anschrift des Verfassers