Abstract
Abstract
Background
Outpatients seek to visit health care facilities for episodes of tachycardia-related signs and symptoms. The challenge for physicians is to balance a proper initial assessment and avoid overlooking a possible arrhythmia. This common clinical situation affects individuals and health care utilization, and effective management may substantially affect health care resources. This study aimed to explore health care utilization for outpatients with episodes of tachycardia visiting health care centres (HCCs) and/or emergency departments (EDs).
Method
This retrospective study used data of adult outpatients (≥ 18 years) who were assessed by a physician as having a specific or nonspecific diagnosis of arrhythmia between 2017 and 2018, and data were retrieved from medical records and a regional registry database. Data was analysed with appropriate statistical analyses to identify disparities between sex, age and terms of search pattern for each health care facility. Analysis of variance was used to test disparities between the sexes, and one-factor ANOVA was used for the incidence of missed arrhythmias.
Results
A total of 2719 visits with 2373 outpatients were included in the study. The result showed a significant difference in the total number of visits (n = 2719) between female and male patients (68% vs. 32%, p < .001). In the 60–69- and 70–79-year age groups, females had significantly higher frequencies of visits than males (p = .018). A significant difference was also observed between sexes in terms of which health care facility they tended to visit (p < .001). Ninety-five percent of the outpatients visiting EDs were hospitalized. When estimating the incidence of missed arrhythmias (diagnoses) in relation to assessments, the results showed a 5% missed diagnosis involving potential atrioventricular nodal re-entry tachycardia and atrioventricular re-entry tachycardia. Moreover, the referral rate was low, especially from HCCs to cardiologists.
Conclusions
This study shows a significant difference in total visits in HCCs and/or EDs by patients of different sexes and indicates the need for improved care for outpatients with episodes of tachycardia. Sex- and age-related differences must be addressed with an aim of providing equal care. Finally, the low rate of referral from HCCs to cardiologists compared to the high proportion of hospitalizations from EDs, deserves further investigation.
Publisher
Springer Science and Business Media LLC
Subject
Cardiology and Cardiovascular Medicine
Reference31 articles.
1. Brugada J, Katrisis D, Arbelo E, Arribas F, Bax J, Blomstrom-Lundqvist C, et al. ESC guidelines for the management of patients with supraventricular tachycardia. Eur Heart J. 2019;2019:1–65.
2. Dewland T, Oesterle A, Stein J, Marcus G. Health care utilization among adenosine-sensitive supraventricular tachycardia patients presenting to the emergency department. J Interv Card Electrophysiol. 2017;49:103–9.
3. Raviele A, Giada F, Bergfeldt L, Blanc J, Blomstrom-Lundqvist C, Mont L, et al. Management of patients with palpitations: a position paper from the European Heart Rhythm Association. Europace. 2011;13(7):920–34.
4. Wood K, Wiener C, Kayser-Jones J. Supraventricular tachycardia and the struggle to be believed. Eur J Cardiovasc Nurs. 2007;6:293–302.
5. Chew D, Sacks N, Emden M, Preib M, Cyr P, Wood D, et al. Trends in health care resource use and expenditures in patients with newly diagnosed supraventricular tachycardia in the United States. Am Heart J. 2021;233:132–40.
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献