Patients presenting to the emergency department: the use of other health care services and reasons for presentation.
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 1,389 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.


CONCLUSIONS
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.
Han
Alice
A
Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Ospina
Maria
M
Blitz
Sandra B
SB
Strome
Trevor
T
Rowe
Brian H
BH
D000328:Adult; D000416:Alberta; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006301:Health Services Needs and Demand; D015277:Hotlines / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D010342:Patient Acceptance of Health Care; D011320:Primary Health Care / Q000706:statistics & numerical data; D012111:Residence Characteristics; D012907:Smoking / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014505:Urban Population