Low-severity musculoskeletal complaints evaluated in the emergency department.
Patients with musculoskeletal disorders represent a considerable percentage of emergency department volume. Although patients with acute or high-severity conditions are encouraged to seek care in the emergency department, patients with nonacute, low-severity conditions may be better served elsewhere. This study prospectively assessed patients presenting to the emergency department with nonacute, low-severity musculoskeletal conditions to test the hypothesis that these patients have access to care outside the emergency department. One thousand ten adult patients with a musculoskeletal complaint were identified, and a detailed questionnaire was completed by 862 (85.3%) during their emergency department stay. Three hundred fifty (40.6%) patients presented with nonacute, low-severity conditions. Patients with nonacute, low-severity problems were less likely to have a primary care physician (62.5% versus 72.3%) or to have medical insurance (82.5% versus 87.7%), but a majority had both (59.3%). Only 14.3% had neither. Forty-four percent of all patients with primary care physicians believed their primary care physician was incapable of managing musculoskeletal problems. Appropriate use of the emergency department by patients with musculoskeletal disorders may require not only increased access to insurance and primary care, but also improved public understanding of the scope of care offered by primary care physicians and the conflicting demands placed on emergency department providers.


METHODS
Level I, prognostic study.
Gaieski
David F
DF
Department of Emergency Medicine, University of Pennsylvania School of Medicine, 34th and Spruce Streets, Ground Ravdin, Philadelphia, PA 19104, USA. gaieskid@uphs.upenn.edu
Mehta
Samir
S
Hollander
Judd E
JE
Shofer
Frances
F
Bernstein
Joseph
J
D000058:Accidental Falls / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019567:Back Injuries / Q000453:epidemiology; D002648:Child; D015897:Comorbidity; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D007348:Insurance, Health; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000175:diagnosis* / Q000628:therapy*; D019838:Neck Injuries / Q000453:epidemiology; D015143:Philadelphia; D011320:Primary Health Care / Q000706:statistics & numerical data; D011446:Prospective Studies; D013180:Sprains and Strains / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data