title: Use of healthcare information and advice among non-urgent patients visiting emergency department or primary care.
abstract: BACKGROUND
  Healthcare information provided by telephone service and internet sources is growing but has not been shown to reduce inappropriate emergency department (ED) visits.
  
  
  OBJECTIVE
  To describe the use of advice or healthcare information among patients with non-urgent illnesses seeking care before attendance at an ED, or primary care (PC) centres in an urban region in Sweden.
  
  
  METHODS
  Patients with non-urgent illnesses seeking care at an ED or patients attending the PC were followed up with a combination of patient interviews, a questionnaire to the treating physician and a prospective follow-up of healthcare use through a population-based registry.
  
  
  RESULTS
  Half of the non-urgent patients attending the ED had used healthcare information or advice before the visit, mainly from a healthcare professional source. In PC, men were more likely to have used information or advice compared with women (OR 2.5 95% CI 1.3 to 5.0), whereas the situation was reversed among ED patients (OR=0.4 95% CI 0.2 to 0.9). Men with no previous healthcare experience attending the ED had the lowest use of healthcare information (p<0.01). Very few in both groups had utilised healthcare information on the internet in a case of perceived emergency.
  
  
  CONCLUSIONS
  ED patients rated as non-urgent by the triage nurse used more advice and healthcare information than PC patients, irrespective of the physician-rated urgency of the symptoms. The problem seems not to be lack of information about appropriate ED use, but to find ways to direct the information to the right target group.
authors.affiliation: Clinical Epidemiology Unit, Department of Medicine, Solna, Karolinska Institutet, Karolinska University Hospital, Eugeniahemmet, T2 SE-171 76 Solna, Sweden. ann-sofie.backman@karolinska.se
authors.forename: Ann-Sofie
authors.initials: AS
authors.lastname: Backman
authors.forename: Magdalena
authors.initials: M
authors.lastname: Lagerlund
authors.forename: Tobias
authors.initials: T
authors.lastname: Svensson
authors.forename: Paul
authors.initials: P
authors.lastname: Blomqvist
authors.forename: Johanna
authors.initials: J
authors.lastname: Adami
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D054626:Consumer Health Information / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013548:Sweden; D014505:Urban Population; D055815:Young Adult