Factors predicting perceived improved health after emergency room visits

This study examines the key factors contributing to perceived improved health after emergency room (ER) visits.

Perceived health is a subjective measure of health status. It is an important and useful concept in nursing and assessment of health services because it reflects the clients' own assessment of his/her health, which may have led to their subsequent health-seeking behaviour.

Secondary analysis of a main study which aimed at examining the effects of nurse follow-up on ER revisits using randomized-controlled trial. In this study, binary logistic regressions were conducted to identify factors associated with the dependent variable, perceived improved health 30 days after the index ER visit. Data were collected from 795 subjects and the sources of data were from medical records and telephone interviews.

Gender, income, usual practice in managing minor illness, what to do other than attending the ER, nurse follow-up, general self-rated health, triage, considered other doctors on the day of index ER visit, times of attending general outpatient clinic and times of attending general practitioner were found to be significantly associated with perceived improved health 30 days after the index ER visit.

Many of the variables identified in this study that predicted perceived improved health concurred with previous findings. What is of interest is that nurse follow-up but not multiple medical consultations helped enhance perceived improved health. We speculate that there was no continuity of care in the multiple medical consultations. Where as in the nurse follow-up, the nurse was able to follow through the care of individuals, monitor their progress and make appropriate referrals. This study shows that the nurse is an appropriate person to mediate the health needs of individuals and the healthcare system and to enhance health maintenance for individuals in the community without excessively using medical services.

The nurses providing care during the transitional phase should not only include the traditional clinical or hospital system variables, but should also take into account the general health perception of patients, because these are the predictors of health services utilization and morbidity.