title: Using the hospital emergency department as a regular source of care.
abstract: OBJECTIVE
  to evaluate the proportion of the patients who report the emergency department as their regular source of care and to describe the demographics and health status of this population.
  
  
  METHODS
  A cross-sectional study was performed at the emergency department in two hospitals (around 12,000 visits per year each). Subjects were interviewed using a standardised questionnaire, before and after the emergency department visit.
  
  
  METHODS
  The medical emergency department of two university hospitals, one in Paris and one in Besançon (France).
  
  
  METHODS
  Each patient aged 15 and more attending the emergency department for a visit during forty randomly selected periods of 12 hours was included.
  
  
  METHODS
  Self report of the utilization of the emergency department as a regular source of care.
  
  
  RESULTS
  Fourteen percent of the patients cited the emergency department as a regular source of care in Paris, and 3.3% in Besançon. In Paris, young age, being born outside of France, homelessness or precarious housing, lack of social support in case of illness and lack of health insurance were independently associated with this health care utilization behavior.
  
  
  CONCLUSIONS
  From a public health point of view, the patients reported to use the emergency department as a primary health care structure should not be considered as 'inappropriate' or 'abusers'. Specific health needs have been found, which would require some continuity of care, a task for which the emergency department is not organised nowadays.
authors.affiliation: Service de Biostatistique et Informatique Médicale, Groupe hospitalier Pitié-Salpétrière, Paris, France. lang@biomath.jussieu.fr
authors.forename: T
authors.initials: T
authors.lastname: Lang
authors.forename: A
authors.initials: A
authors.lastname: Davido
authors.forename: B
authors.initials: B
authors.lastname: Diakité
authors.forename: E
authors.initials: E
authors.lastname: Agay
authors.forename: J F
authors.initials: JF
authors.lastname: Viel
authors.forename: B
authors.initials: B
authors.lastname: Flicoteaux
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D005602:France; D015438:Health Behavior; D006300:Health Services Misuse / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011320:Primary Health Care / Q000706:statistics & numerical data*; D017678:Sex Distribution; D012959:Socioeconomic Factors