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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

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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

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