Hostname: page-component-848d4c4894-v5vhk Total loading time: 0 Render date: 2024-06-22T03:09:15.815Z Has data issue: false hasContentIssue false
  • English
  • Français

Patients presenting to the emergency department: the use of other health care services and reasons for presentation

Published online by Cambridge University Press:  21 May 2015

Alice Han ,
Maria B. Ospina ,
Sandra Blitz ,
Trevor Strome  and
Brian H. Rowe
Alice Han
Affiliation:
Faculty of Medicine, University of Toronto, Toronto, Ont.
Maria B. Ospina
Affiliation:
School of Public Health, University of Alberta, Edmonton, Alta. Department of Emergency Medicine, University of Alberta, Edmonton, Alta.
Sandra Blitz
Affiliation:
Department of Emergency Medicine, University of Alberta, Edmonton, Alta.
Trevor Strome
Affiliation:
Winnipeg Regional Health Authority, Winnipeg, Man.
Brian H. Rowe*
Affiliation:
School of Public Health, University of Alberta, Edmonton, Alta. Department of Emergency Medicine, University of Alberta, Edmonton, Alta. University of Alberta Evidence-Based Practice Centre, University of Alberta, Edmonton, Alta.
*
Department of Emergency Medicine, University of Alberta, 1G1.43 WMC, 8440-112 St., Edmonton AB T6G 2B7; brian.rowe@ualberta.ca

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objective:

Some low-acuity emergency department (ED) presentations are considered convenience visits and potentially avoidable with improved access to primary care services. This study assessed the frequency and determinants of patients' efforts to access alternative care before ED presentation.

Methods:

Patients aged 17 years and older were randomly selected from 2 urban ED sites in Edmonton. Survey data were collected on use and characteristics of alternative care before the ED visit. Information was also collected on patient demographics and factors influencing their perception of whether the ED was the best care option.

Results:

Of the 1389 patients approached, 905 (65%) completed the survey and data from 894 participants were analyzed. Sixty-one percent reported that they sought alternative care before visiting the ED. Eighty-nine of the patients who attempted alternative access before the ED visit felt that the ED was their best care option. Results of the multivariate logistic regression analysis showed that injury presentation, living arrangements, smoking status and whether or not patients had a family practitioner were predictors for seeking alternative care before visiting the ED.

Conclusion:

Most ambulatory patients attempt to look for other sources of care before presenting to the ED. Despite this attempted access to alternative care, while patients wait for ED care, they perceive that the ED is their best care option at that point in time.

Keywords

emergency departmentprimary care provideraccess to caretriageovercrowding
Type
Original Research • Recherche originale
Information
Canadian Journal of Emergency Medicine , Volume 9 , Issue 6 , November 2007 , pp. 428 - 434
Copyright
Copyright © Canadian Association of Emergency Physicians 2007

References

1.Chan, BTB, Schull, MJ, Schultz, SE. Atlas report: emergency department services in Ontario: 1993–2000. Toronto (ON): Institute for Clinical Evaluative Sciences; 2001.Google Scholar
2.Holroyd, BR, Rowe, BH. Presentations to the emergency department in Alberta. Edmonton (AB): Alberta Health and Wellness; 2002.Google Scholar
3.American Academy of Family Practice. Official AAFP definition of primary care. Am Fam Physician 1975;2:1.Google Scholar
4.Han, A, Russell, B, Blitz, S, et al. The relationship between preventive health practices of emergency department patients and access to family physicians [abstract]. Can J Emerg Med 2005;7:195.Google Scholar
5.Rowe, BH, Bond, K, Ospina, MB, et al. Emergency department overcrowding in Canada: What are the issues and what can be done? [Technology overview no 21]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2006.Google Scholar
6.Miller, KE, Lairson, DR, Kapadia, AS, et al. Patient characteristics and the demand for care in two freestanding emergency centers. Inquiry 1985;22:418–25.Google ScholarPubMed
7.Cunningham, PJ, Clancy, CM, Cohen, JW, et al. The use of hospital emergency departments for nonurgent health problems: a national perspective. Med Care Res Rev 1995;52:453–74.Google Scholar
8.Baker, DW, Stevens, CD, Brook, RH. Regular source of ambulatory care and medical care utilization by patients presenting to a public hospital emergency department. JAMA 1994;271:1909–12.Google Scholar
9.Canadian Emergency Department and Triage and Acuity Scale: Implementation Guidelines. Can J Emerg Med 1999;1(Suppl 1): S1–S24.Google Scholar
10.2001 Canadian Census. Ottawa (ON): Statistics Canada; 2001.Google Scholar
11.Schoen, C, Osborn, R, Huynh, PT, et al. Primary care and health system performance: adults’ experiences in five countries. Heath Aff (Millwood) 2004;(Suppl W4):487–503.Google ScholarPubMed
12.Afilalo, M, Guttman, A, Colacone, A, et al. Emergency department use and misuse. J Emerg Med 1995;13:259–64.CrossRefGoogle ScholarPubMed
13.Canadian Community Health Survey. Ottawa (ON): Statistics Canada; 2003.Google Scholar
14.Canadian Institute for Health Information. Understanding emergency department waiting times: who is using emergency departments and how long are they waiting? Ottawa (ON): The Institute; 2006.Google Scholar
15.Shesser, R, Kirscsh, T, Smith, J, et al. An analysis of emergency department use by patients with minor illness. Ann Emerg Med 1991;20:743–8.Google Scholar
16.Asplin, BR. Access, quality, and cost control in emergency medicine: Can we have all three? Ann Emerg Med 1997;30:779–81.Google Scholar
17.Dong, SL, Bullard, MJ, Meurer, DP, et al. Predictive validity of a computerized emergency triage tool. Acad Emerg Med 2007;14:16–21.CrossRefGoogle ScholarPubMed
18.Afilalo, J, Marinovich, A, Afilalo, M, et al. Nonurgent emergency department patient characteristics and barriers to primary care. Acad Emerg Med 2004;11:1302–10.Google Scholar
19.Gill, JM, Riley, AW. Nonurgent use of hospital emergency departments: Urgency from the patient’s perspective. J Fam Pract 1996;42:491–6.Google Scholar