Rate, Mode, Reasons and Factors Associated With Re-Presentation in People Diagnosed With Musculoskeletal Conditions at a Single Emergency Department: A Cross-Sectional Exploratory Study

IF 1.4 4区医学 Q2 EMERGENCY MEDICINE

Emergency Medicine Australasia Pub Date : 2025-08-29 DOI:10.1111/1742-6723.70128

Patricia Slapp, Linda Spencer, Rob Waller, Karen Richards, Anne Smith, Nic Saraceni, Piers Truter

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引用次数: 0

Abstract

Objective

To explore the rate, mode, and reasons for re-presentations for emergency department (ED) patients with musculoskeletal diagnoses and examine factors associated with increased odds of re-presentation.

Methods

A retrospective cross-sectional audit of re-presentation patterns for patients with musculoskeletal diagnoses presenting to the study ED in 2023.

The study ED was in a secondary hospital in Perth, Western Australia, which operates a diversion pathway (daily, 10 am–6 pm) for patients with musculoskeletal diagnoses.

Results

In 2023, 3677 patients with musculoskeletal diagnoses were diverted from the ED, 972 provided research consent and of those, 143 (14.7%) re-presented. Importantly, 10 (1.0%) patients re-presented to the ED itself, and 133 (13.7%) re-presented to the physiotherapy outpatient diversion clinic.

There were 65 scheduled and 78 unscheduled re-presentations, with telehealth the preferred mode of contact (n = 86, 60.1%). Clinician diagnostic uncertainty, identified patient psychosocial issues, and concern that the patient would re-present to the ED most commonly resulted in scheduled re-presentation (n = 31, 47.7%). Unscheduled re-presentations focused on administrative inquiries (e.g., hospital referrals, medical certificates) (n = 31, 39.7%) and concern for symptoms (n = 25, 32.1%).

Older age, high pain severity, and lower limb affected body region were associated with increased odds of re-presentation.

Conclusions

ED clinicians may reduce re-presentation by employing targeted strategies such as shared decision-making about pain management, ensuring a shared understanding of the diagnosis, or stage of the diagnostic process and likely course of symptoms. Further, a follow-up plan that is clinically indicated and patient acceptable may be critical for those with increased odds of re-representation.

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查看原文本刊更多论文

在单一急诊科诊断为肌肉骨骼疾病的患者再次出现的比率、模式、原因和因素：一项横断面探索性研究

目的探讨急诊科（ED）肌肉骨骼诊断患者的再诊率、模式和原因，并探讨与再诊率增加相关的因素。方法对2023年出现在研究ED的肌肉骨骼诊断患者的再表现模式进行回顾性横断面审计。研究ED在西澳大利亚珀斯的一家二级医院进行，该医院为患有肌肉骨骼诊断的患者提供分流通道（每天上午10点至下午6点）。结果2023年，3677例肌肉骨骼诊断患者从急诊科转出，972例提供了研究同意，其中143例（14.7%）重新就诊。重要的是，10名（1.0%）患者再次出现在急诊科，133名（13.7%）患者再次出现在物理治疗门诊转移诊所。有65例计划复诊和78例计划外复诊，远程医疗是首选的联系方式（n = 86, 60.1%）。临床医生诊断的不确定性，确定的患者心理社会问题，以及担心患者会再次出现在急诊科最常见的结果是再次出现（n = 31, 47.7%）。计划外的再陈述集中在行政询问（例如，医院转诊、医疗证明）（n = 31, 39.7%）和对症状的关注（n = 25, 32.1%）。年龄较大，疼痛严重程度高，下肢受影响的身体部位与再次出现的几率增加有关。结论：ED临床医生可以通过采用有针对性的策略，如共同制定疼痛管理决策，确保对诊断的共同理解，或诊断过程的阶段和症状的可能过程，来减少再次出现。此外，临床适应症和患者可接受的随访计划可能对那些再次出现的几率增加至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Emergency Medicine Australasia 医学-急救医学

CiteScore

3.70

自引率

13.00%

发文量

217

审稿时长

6-12 weeks

期刊介绍： Emergency Medicine Australasia is the official journal of the Australasian College for Emergency Medicine (ACEM) and the Australasian Society for Emergency Medicine (ASEM), and publishes original articles dealing with all aspects of clinical practice, research, education and experiences in emergency medicine. Original articles are published under the following sections: Original Research, Paediatric Emergency Medicine, Disaster Medicine, Education and Training, Ethics, International Emergency Medicine, Management and Quality, Medicolegal Matters, Prehospital Care, Public Health, Rural and Remote Care, Technology, Toxicology and Trauma. Accepted papers become the copyright of the journal.