Acad
Emerg Med 1999 Mar;6(3):178-83.
Patient satisfaction with an emergency department asthma observation unit.
Rydman RJ, Roberts RR, Albrecht GL, Zalenski RJ, McDermott M.
Division of Health Policy and Administration, School of Public Health,
University of Illinois at Chicago, USA. rjrydman@uic.edu
OBJECTIVE: To compare levels of patient satisfaction
between the diagnostic and treatment protocols in an ED-based asthma observation
unit (AOU) and those with standard inpatient hospitalization.
METHODS: This was a prospective, randomized, controlled
trial with a sample of 163 patients presenting to the ED with acute asthma
exacerbations over a 30-month period. Eligible patients were those who
could not resolve their symptoms after three hours of standard ED therapy.
Patients were then randomly assigned to an ED-based AOU (experimental
group) or to customary inpatient care (control group). Patient satisfaction
and problems with care processes were assessed by standardized instrumentation
at discharge in both groups.
RESULTS: The AOU patients scored higher than those randomized
to the inpatient hospitalization protocol on four summary ratings of patient
satisfaction measures: received service wanted, recommendation of the
service to others, satisfaction with the service, and overall satisfaction.
The AOU patients reported fewer total number of problems with care received,
and fewer specific problems with communication, emotional support, physical
comfort, and special needs, than did the inpatient group. However, the
AOU patients reported more problems regarding their knowledge of financial
costs and liabilities for their service than did the inpatients.
CONCLUSION: Patients were more satisfied and had fewer
problems with rapid diagnosis and treatment in the AOU than they did with
routine inpatient hospitalization. Since AOUs represent a new ambulatory
service modality, patients would benefit from greater awareness of the
costs and coverage for AOUs as compared with hospital inpatient care.
These findings have important implications for the future short- and long-term
success and feasibility of ED-based AOUs.
Publication Types: Clinical Trial; Randomized Controlled Trial
PMID: 10192667 [PubMed - indexed for MEDLINE]
