Psychoemotional, Cultural, and Social Factors Directly Impact Reconsultations in the Emergency Servic

- Research

A recent study, featured in the scientific journal 'Emergencias,' has unveiled a direct correlation between the presence of two or more factors, such as illiteracy, anxiety, or the absence of caregivers, and the likelihood of patients returning to the Emergency Service within 30 days

Early warnings based on these factors can assist ED teams in identifying potential returning patients

This research offers valuable insights for crafting specific strategies aimed at enhancing the continuity of care through primary care and social services, thus reducing the strain on the healthcare system caused by frequent re-visits to the Emergency Service

The principal investigator of the study is a nurse in the Emergency Department at Bellvitge Hospital and a member of the Nursing Research Group at the Bellvitge Biomedical Research Institute

A recent study underscores the direct impact of psychoemotional, cultural, and social factors on reconsultations to the Emergency Service. This research, spearheaded by Andrea Urbina, a nurse at the Emergency Service of the Bellvitge University Hospital (HUB) and a researcher in the nursing research group GRIN-IDIBELL, reveals that patients' emotional and social well-being play a crucial role. In fact, it indicates that patients with more complex conditions are more likely to seek medical attention again within 30 days after being discharged from the Emergency Service.

Traditionally, the patient's biological realm has received more attention in research, specifically in examining how factors like age and medical conditions relate to adverse health outcomes. Nevertheless, there are additional facets of care complexity that also exert an influence on the patient's progression, including the socio-cultural and psycho-emotional dimensions.

"This study demonstrates the significance, for healthcare practice, of comprehensively assessing all aspects of a patient's well-being, rather than focusing solely on their medical condition, when addressing their healthcare needs. Emotional well-being, cultural background, and social factors may serve as pivotal elements that impact how frequently an individual seeks care in emergency services," remarks nurse Andrea Urbino.

Evidence for a better continuity of care in the health system

Data collected from 15,556 patient episodes attended to at HUB's Emergency Services reveal that 82.4% of them present some form of care complexity.

Furthermore, approximately 12% of patients revisit the Emergency Department for consultations within 30 days of discharge. Among the factors most frequently linked to these reconsultations are incontinence, haemodynamic instability, risk of haemorrhage, advanced age, anxiety, fear, impaired cognitive functions, and illiteracy. This study

underscores that reconsultations are also influenced by socio-economic and cultural factors, as well as issues related to comprehensive health and social vulnerability."

Incorporating this information as an alert within the electronic medical records could assist Emergency Service teams in identifying patients at a heightened risk of needing urgent care again. This, in turn, enables the development of strategies aimed at enhancing continuity of care while simultaneously mitigating the economic impact on the healthcare system," explains the nurse from HUB's Emergency Service.

The findings of this study present a range of challenges and opportunities. These include the potential establishment of novel approaches for patient follow-up with primary care providers, the improvement of care continuity, and coordination with social services professionals upon discharge.

A Decade of State-of-the-Art Nursing Research at Bellvitge

This study has been published in the esteemed scientific journal 'Emergencias,' renowned as one of the leading journals in the global field of emergency care. The study's authors are members of the GRIN-IDIBELL nursing research group, a team that has dedicated over a decade to investigating the intricacies of patient care. This research group has been under the leadership of Dr Maria Eulàlia Juvé.

Dr Juvé is known for the creation of the ATIC terminology within the nursing knowledge architecture, a significant contribution developed within the framework of the Institut Català de la Salut.

The publication of this article has been accompanied by an editorial that underscores the significance of advancing research in the realm of care complexity, with the overarching challenge of “embracing a holistic nursing perspective in patient assessment."

Precisely, GRIN-IDIBELL work together in the Complex Patient line to open future lines of research on the impact of the care complexity on patients’ health outcomes.

This recent study constitutes a segment of the doctoral thesis conducted by nurse Andrea Urbina, under the guidance of Dr Jordi Adamuz, a research support nurse at the Bellvitge University Hospital, and Dr Marta Romero, a professor at the Faculty of Nursing at the University of Barcelona.

Reference article

Urbina, A; Juvé-Udina, M.E; Romero-García, M; Delgado-Hito, P; González-Samartino, M; Adamuz, J; 2023. Factores de complejidad de cuidados asociados a la reconsulta en un servicio de urgencias. Emergencias (Revista Científica de la Sociedad Española de Medicina de Urgencias y Emergencias). Read it here: