title: Judging a patient's decision to seek emergency healthcare: clues for managing increasing patient demand.
abstract: OBJECTIVE
  In recent years, the concept of an 'inappropriate' emergency department or ambulance user has arisen. This discussion paper explores definition and measurement of inappropriate emergency healthcare utilisation, and the effect on demand.
  
  
  METHODS
  A comprehensive literature review of published articles was conducted.
  
  
  RESULTS
  Exploration of the definitions of 'inappropriate' emergency healthcare utilisation identified two patient cohorts; emergency healthcare utilisation by those who are not experiencing a health emergency, and those who do not seek emergency healthcare who should. Several position papers from Australian and international sources emphasised the patient's right to access emergency healthcare when they feel the need, and the responsibility of emergency healthcare workers to provide treatment to all patients. Differences between medical classifications of urgency based on physiological measures are contrasted with patient-based determination of urgency, which is defined by psychosocial factors.
  
  
  CONCLUSIONS
  This literature review raises questions about patients' understanding of the role of emergency healthcare services in an emergency. This has implications for determining the patient's point of access to the health system in an acute health event, and offers an opportunity to selectively educate patients and carers to change help-seeking behaviours to suit the health system resources and moderate patient demand.
authors.affiliation: Ambulance Victoria, Doncaster, Vic. 3175, Australia. amee.morgans@ambulance.vic.gov.au
authors.forename: Amee
authors.initials: A
authors.lastname: Morgans
authors.forename: Stephen
authors.initials: S
authors.lastname: Burgess
mesh_terms: D003657:Decision Making; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D006300:Health Services Misuse / Q000639:trends; D006301:Health Services Needs and Demand / Q000639:trends*; D006801:Humans; D010342:Patient Acceptance of Health Care