title: Why non-urgent patients choose emergency over primary care services? Empirical evidence and managerial implications.
abstract: OBJECTIVE
  To investigate structural and psychological factors that lead non-urgent patients to choose the Accidents & Emergency Department (A&ED) rather than primary care services.
  
  
  METHODS
  Data were collected through interviews by means of a structured questionnaire. Data regarding the A&ED sample were also drawn from the database of the department.
  
  
  METHODS
  Hypotheses were tested in a survey comparing A&ED non-urgent patients and patients using GP surgeries. Different perceptions of the characteristics of A&ED and primary care services were measured and a perceptual map was created using the linear discriminant analysis (LDA).
  
  
  METHODS
  Emergency services users were interviewed in the A&ED of the General Hospital of the Province of Macerata (Italy). Primary care users were interviewed in four GP surgeries. 527 patients were interviewed between December 2006 and February 2007.
  
  
  RESULTS
  A&ED and primary care patients look for different characteristics as diagnostic and therapeutic potentialities, empathy and competence, quick access or long-lasting relationship. Information asymmetry explains part of the behaviour.
  
  
  CONCLUSIONS
  Use of A&ED services for non-urgent care can be reduced. The understanding of reasons underlying the choice and a change in access, timing and contents of care/services provided by general practitioners (GPs) might provide incentives for shifting from A&ED to GPs surgeries.
authors.affiliation: Bocconi University, Milano, Italy. federico.lega@unibocconi.it
authors.forename: Federico
authors.initials: F
authors.lastname: Lega
authors.forename: Alessandro
authors.initials: A
authors.lastname: Mengoni
mesh_terms: D000328:Adult; D000368:Aged; D002755:Choice Behavior; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D036262:Empirical Research; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D007558:Italy; D008297:Male; D008875:Middle Aged; D010361:Patients / Q000523:psychology; D011320:Primary Health Care / Q000706:statistics & numerical data*; D055815:Young Adult