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    Evaluation of Children’s Usage of Emergency Departments in Turkey
    (Gece Kitaplığı, 2021) Bütün, Ahmet; Linden, Mark; Lynn, Fiona; McGaughey, Jennifer
    Emergency Departments (EDs) provide immediate and emergency care for patients with life-threatening medical conditions, trauma or injuries – they should not treat minor illnesses or provide primary care (Chamberlain & Carraccio, 1994; Chande et al., 1996; Liu et al., 1999). However, the American College of Emergency Physicians (1990) stated that increasing visits with medically non-urgent conditions is something which greatly concerns healthcare professionals and administrators because of the medical and economic implications.
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    Exploring attendance at emergency departments for children with non-urgent conditions in Turkey: a qualitative study of parents and healthcare staff perspectives
    (Wolters Kluwer, 2022) Bütün, Ahmet; Lynn, Fiona; McGaughey, Jennifer; McLaughlin, Katrina; Linden, Mark
    Background: Overcrowding in Emergency Departments (EDs) is a significant global concern with negative consequences for patients, healthcare staff, and healthcare systems. The use of EDs by parents of children with non-urgent conditions is associated with overcrowding, higher healthcare costs, lower quality of care, and longer waiting times. Research in this area has largely been conducted in high-income countries, with a dearth of work originating in middle and low-income regions. The aim of this study was to explore the reasons for parents attending EDs with their child for non-urgent conditions in Turkey. Method: Semi-structured interviews were conducted with 13 parents, 15 ED staff, and 10 General Practitioners (GPs) in 2 regions of Turkey between March and May 2017. Data were analyzed using the principles of grounded theory. Results: The findings were classified into 5 core categories: (1) parents’ feelings, knowledge, and perceived inability to provide self-care; (2) perceived limitations of healthcare services, system, and staff; (3) parents’ preferences for hospital and ED services; (4) adverse impact on ED services; and (5) perceived needs for care. Conclusion: This is the first study conducted in a middle-income country regarding parental reasons for using the ED for nonurgent conditions. Greater efforts must be made to reduce unnecessary visits to the ED to better meet service user needs and to increase the satisfaction of both parents and healthcare staff. The findings of this study may inform healthcare providers, policymakers, healthcare staff, and researchers to design interventions in order to mitigate overcrowding in the ED.
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    Exploring attendance at emergency departments for children with non-urgent conditions in Turkey: A qualitative study of parents and healthcare staff perspectives
    (Emergency and Critical Care Medicine, 2022) Bütün, Ahmet; Lynn, Fiona; McGaughey, Jennifer; McLaughlinc, Katrina; Linden, Mark
    Background: Overcrowding in Emergency Departments (EDs) is a significant global concern with negative consequences for patients, healthcare staff, and healthcare systems. The use of EDs by parents of children with non-urgent conditions is associated with overcrowding, higher healthcare costs, lower quality of care, and longer waiting times. Research in this area has largely been conducted in high-income countries, with a dearth of work originating in middle and low-income regions. The aim of this study was to explore the reasons for parents attending EDs with their child for non-urgent conditions in Turkey. Method: Semi-structured interviews were conducted with 13 parents, 15 ED staff, and 10 General Practitioners (GPs) in 2 regions of Turkey between March and May 2017. Data were analyzed using the principles of grounded theory. Results: The findings were classified into 5 core categories: (1) parents’ feelings, knowledge, and perceived inability to provide self-care; (2) perceived limitations of healthcare services, system, and staff; (3) parents’ preferences for hospital and ED services; (4) adverse impact on ED services; and (5) perceived needs for care. Conclusion: This is the first study conducted in a middle-income country regarding parental reasons for using the ED for nonurgent conditions. Greater efforts must be made to reduce unnecessary visits to the ED to better meet service user needs and to increase the satisfaction of both parents and healthcare staff. The findings of this study may inform healthcare providers, policymakers, healthcare staff, and researchers to design interventions in order to mitigate overcrowding in the ED.
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    Exploring attendance at emergency departments for children with non-urgent conditions in Turkey: A qualitative study of parents perspectives
    (2021) Bütün, Ahmet; Lynn, Fiona; McGaughey, Jennifer; McLaughlin, Katrina; Linden, Mark
    Background: Non-urgent visits to Emergency Departments (EDs) are on the increase, and the pressure on EDs is a significant concern globally. The use of EDs by parents of children with non-urgent conditions is an important and unresolved problem, associated with overcrowding, higher costs, lower quality of care and longer waiting times. The majority of research on this topic has taken place in high-income countries with a dearth of work originating in middle and low-income regions. The aim of this study was to explore reasons for parents attending EDs with their child for non-urgent conditions in Turkey. Methodology: This study utilised a qualitative approach. Semi-structured interviews were conducted with thirteen parents in two regions of Turkey between March and May 2017. Data were analysed using principles of grounded theory. Findings: Parents’ perspectives were classified into five core categories: (1) parents’ feelings, knowledge, and ability to provide self-care; (2) perceived needs for care; (3) limitations of healthcare services/system and staff; (4) trust with ED services, greater resources, convenience and access; and (5) experiences with ED services and the consequences of ED overcrowding. Parents expressed how their feelings regarding their children affected their decision-making processes in relation to healthcare services utilisation. Parents reported that they were worried, anxious, and nervous as well as expressing their fears when their child was sick, and how such parental feelings may have influenced them to use the ED. In addition, low health literacy amongst parents, a limited ability to provide self-care and, therefore, being less capable to manage common childhood illnesses affected ED utilisation. Furthermore, parents perceived their child’s condition as urgent and thought that they would need an ED visit. Moreover, greater trust in ED services, greater resources, being more convenient and ease of access had influenced parents in relation to using the ED rather than their GP. Finally, parents expressed their experiences with using the ED and reported how overcrowding in the ED affected ED services, ED staff and patients. These adverse impacts of ED overcrowding included dissatisfaction, staff occupational stress, lack of interest, being unable to treat patients effectively, poor patient outcomes which led parents to revisit the ED or other healthcare services. Conclusion: This is the first Turkish-based study on parents’ reasons for using EDs for their children with non-urgent conditions. The study identified how ED use is a complex and multi-dimensional issue. This study may inform healthcare providers and policymakers to better understand this issue and help to design high impact solutions and interventions to mitigate overcrowding in EDs. Greater effort must be made to reduce unnecessary visits to the ED to meet service user needs, and to increase satisfaction of both parents and healthcare staff.