title: Uncovering factors affecting use of the emergency department for less urgent health problems in urban and rural areas.
abstract: People who access the emergency department for less urgent health problems have been described as inappropriate users of the health-care system.Yet little is known about the factors precipitating such use and how these differ based on location of the emergency department. In this descriptive-correlational study guided by Andersen's Model of Health Services Use, 1612 people who presented to an emergency department with a less urgent health problem were interviewed. Analysis revealed rural/urban differences in the characteristics of patients, nature of the problems, actions taken, and factors precipitating the visit. Despite its popularity, the predictive capabilities of Andersen's model were limited in explaining use of self-treatment or willingness to wait for treatment. The findings show that an emergency department's roles and functions vary according to its location. Such insights provide direction for developing services that respond to the needs of people with less urgent health problems that are cognizant of geographic location.
authors.affiliation: Faculty of Nursing, University of New Brunswick, Fredericton, Canada. mhodgins@unb.ca
authors.forename: Marilyn J
authors.initials: MJ
authors.lastname: Hodgins
authors.forename: Judith
authors.initials: J
authors.lastname: Wuest
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility; D006300:Health Services Misuse / Q000706:statistics & numerical data*; D006302:Health Services Research; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D009042:Motivation; D020380:Needs Assessment; D009509:New Brunswick; D015404:Nursing Methodology Research; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D012111:Residence Characteristics; D019035:Rural Health Services / Q000706:statistics & numerical data*; D012648:Self Care / Q000379:methods / Q000523:psychology; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D019037:Urban Health Services / Q000706:statistics & numerical data*