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Effectiveness of Nonemergency Care Via an Emergency Room
A Study of 116 Patients with Gastrointestinal Symptoms
- ROBERT H. BROOK, M.D., ScD.;
- MORRIS H. BERG, B.A.; and
- PHILIP A. SCHECHTER, B.A.
Abstract
This study evaluated the care received by 166 patients with gastrointestinal symptoms seen in the Johns Hopkins Hospital Emergency Room and referred for X rays. Using data from chart reviews and patient interviews 4 months after the initial visit, the process of medical care and patients' functional capacities were measured. Seventy-five percent of the patients completed their X rays, and 44% of those X rayed and interviewed knew their results. Using explicit criteria, the process was judged adequate for 75 patients (45%). Of the 157 patients interviewed, 1 had died; 27 had the same or increased symptoms; 61 had fewer symptoms; 68 were asymptomatic; 53 were doing less work, 84 the same amount, and 19 more. No significant relationship was found between the adequacy of the medical care process and change in functional capacity. Combining these two indicators, quality of care was judged acceptable for 41 of 161 patients (25%).
Article and Author Information
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▸ From the Carnegie-Commonwealth Clinical Scholar Program of the Johns Hopkins University and the Department of Medical Care and Hospitals, Johns Hopkins University School of Hygiene and Public Health, Baltimore, Maryland.
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Supported in part by grants 5R01HS00110 and 5T01HS00112 from the National Center for Health Services Research and Development, National Institutes of Health, Bethesda, Md., and by the Carnegie Corporation and Commonwealth Fund. Dr. Brook was a Carnegie-Commonwealth Clinical Scholar.
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▸ Address reprint requests to Robert H. Brook, M.D., 12201 Village Square Terrace, Apt. 201, Rockville, MD 20852.
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- Received September 15, 1972.
- Accepted December 8, 1972.
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