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Emergency Department Discharge Outcome and Psychiatric Consultation in North African Patients

Author

Listed:
  • Osnat Keidar

    (Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
    Both authors contributed equally to the manuscript.)

  • Sabrina N. Jegerlehner

    (Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
    Both authors contributed equally to the manuscript.)

  • Stephan Ziegenhorn

    (Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland)

  • Adam D. Brown

    (Department of Psychology, New School for Social Research, New York, NY 10011, USA
    Department of Psychiatry, New York University School of Medicine, New York, NY 10016, USA)

  • Martin Müller

    (Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
    Institute of Health Economics and Clinical Epidemiology, University Hospital of Cologne, 50935 Cologne, Germany)

  • Aristomenis K. Exadaktylos

    (Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland)

  • David S. Srivastava

    (Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland)

Abstract

Studies in Europe have found that immigrants, compared to the local population, are more likely to seek out medical care in Emergency Departments (EDs). In addition, studies show that immigrants utilize medical services provided by EDs for less acute issues. Despite these observed differences, little is known about the characteristics of ED use by North African (NA) immigrants. The main objective of this study was to examine whether there were differences in ED discharge outcomes and psychiatric referrals between NA immigrants and Swiss nationals. A retrospective analysis was conducted using patient records from NA and Swiss adults who were admitted to the ED of the University Hospital in Bern (Switzerland) from 2013–2016. Measures included demographic information as well as data on types of admission. Outcome variables included discharge type and psychiatric referral. A total of 77,619 patients generated 116,859 consultations to the ED, of which 1.1 per cent ( n = 1338) were consultations by NA patients. Compared to Swiss national patients, NA patients were younger, with a median age of 38.0 (IQR 28–51 years vs. 52.0 (IQR 32–52) for Swiss and predominantly male (74.4% vs. 55.6% in the Swiss). NA patient admission type was more likely to be “walk-in” or legal admission (7.5% vs 0.8 in Swiss,). Logistic regressions indicated that NA patients had 1.2 times higher odds (95% CI 1.07–1.40, p < 0.003) of receiving ambulatory care. An effect modification by age group and sex was observed for the primary outcome “seen by a psychiatrist”, especially for men in the 16–25 years age group, whereby male NA patients had 3.45 times higher odds (95% CI: 2.22–5.38) of having being seen by a psychiatrist. In conclusion differences were observed between NA and Swiss national patients in ED consultations referrals and outcomes, in which NA had more ambulatory discharges and NA males, especially young, were more likely to have been seen by psychiatrist. Future studies would benefit from identifying those factors underlying these differences in ED utilization.

Suggested Citation

  • Osnat Keidar & Sabrina N. Jegerlehner & Stephan Ziegenhorn & Adam D. Brown & Martin Müller & Aristomenis K. Exadaktylos & David S. Srivastava, 2018. "Emergency Department Discharge Outcome and Psychiatric Consultation in North African Patients," IJERPH, MDPI, vol. 15(9), pages 1-11, September.
    • Handle: RePEc:gam:jijerp:v:15:y:2018:i:9:p:2033-:d:170407
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    References listed on IDEAS

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    1. Timothy J. Hatton, 2004. "Seeking asylum in Europe [‘Violence against citizens in civil wars: looting or terror?’]," Economic Policy, CEPR, CESifo, Sciences Po;CES;MSH, vol. 19(38), pages 6-62.
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    1. Osnat Keidar & David S. Srivastava & Emmanouil Pikoulis & Aristomenis K. Exadaktylos, 2019. "Health of Refugees and Migrants—Where Do We Stand and What Directions Should We Take?," IJERPH, MDPI, vol. 16(8), pages 1-8, April.
    2. Karsten Klingberg & Adrian Stoller & Martin Müller & Sabrina Jegerlehner & Adam D. Brown & Aristomenis Exadaktylos & Anne Jachmann & David Srivastava, 2020. "Asylum Seekers and Swiss Nationals with Low-Acuity Complaints: Disparities in the Perceived level of Urgency, Health Literacy and Ability to Communicate—A Cross-Sectional Survey at a Tertiary Emergenc," IJERPH, MDPI, vol. 17(8), pages 1-11, April.

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