Emergency Departments as Care Providers for Patients with Cardiac Ambulatory Care Sensitive and Mental Health Conditions: Qualitative Interview and Focus Group Study with Patients and Physicians

Martina Schmiedhofer, Anna Slagman, Stella Linea Kuhlmann, Andrea Figura, Sarah Oslislo, Anna Schneider, Liane Schenk, Matthias Rose and Martin Möckel
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Martina Schmiedhofer: Departments of Emergency and Acute Medicine, Campus Mitte and Virchow-Klinikum, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany
Anna Slagman: Departments of Emergency and Acute Medicine, Campus Mitte and Virchow-Klinikum, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany
Stella Linea Kuhlmann: Departments of Emergency and Acute Medicine, Campus Mitte and Virchow-Klinikum, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany
Andrea Figura: Department of Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany
Sarah Oslislo: Institute of General Practice, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany
Anna Schneider: Institute of Medical Sociology and Rehabilitation Science, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany
Liane Schenk: Institute of Medical Sociology and Rehabilitation Science, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany
Matthias Rose: Department of Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany
Martin Möckel: Departments of Emergency and Acute Medicine, Campus Mitte and Virchow-Klinikum, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany

IJERPH, 2022, vol. 19, issue 10, 1-17

Abstract: Mental health conditions are frequent among patients with somatic illnesses, such as cardiac diseases. They often remain undiagnosed and are related to increased utilization of outpatient services, including emergency department care. The objective of this qualitative study was to investigate the significance of the emergency department in the patients’ course of treatment and from the physicians’ perspective. An improved understanding of the subjective needs of this specific patient group should provide hints for targeted treatment. This study is part of the prospective EMASPOT study, which determined the prevalence of mental health conditions in emergency department patients with cardiac ambulatory care sensitive conditions. The study on hand is the qualitative part, in which 20 semi-structured interviews with patients and a focus group with six ED physicians were conducted. Data material was analyzed using the qualitative content analysis technique, a research method for systematically identifying themes or patterns. For interpretation, we used the “typical case approach”. We identified five “typical patient cases” that differ in their cardiac and mental health burden of disease, frequency and significance of emergency department and outpatient care visits: (1) frequent emergency department users with cardiac diseases and mental health conditions, (2) frequent emergency department users without cardiac diseases but with mental health conditions, (3) needs-based emergency department users with cardiac diseases; (4) targeted emergency department users as an alternative to specialist care and (5) patients surprised by initial diagnose of cardiac disease in the emergency department. While patients often perceived the emergency department visit itself as a therapeutic benefit, emergency department physicians emphasized that frequent examinations of somatic complaints can worsen mental health conditions. To improve care, they proposed close cooperation with the patients’ primary care providers, access to patients’ medical data and early identification of mental health conditions after cardiac diagnoses, e.g., by an examination tool.

Keywords: ambulatory care sensitive conditions; cardiac diseases; emergency department; frequent user; health care research; mental health conditions; qualitative research (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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