title: Measuring patients' help-seeking decisions: results of a pilot-scale survey using a newly developed tool.
abstract: OBJECTIVE
  The aim of the study was to establish the scale and cost of ineffectively made consultations by self-referring patients across three North Wales primary care practices for 'day-to-day' conditions.
  
  
  BACKGROUND
  Little evidence exists of the scale of ineffectively made day-to-day help-seeking by self-referral patients. Examination of this issue is compromised by the use of traditional language to describe help-seeking, which is subjective and of limited use. There is little understanding about help-seeking for day-to-day conditions. Most research on help-seeking behaviour has considered help-seeking for specific services; specific cohorts; or specific conditions, rather than help-seeking for day-to-day conditions.
  
  
  METHODS
  A survey of all routine consultations made at four general practices in North Wales over a one-week period was conducted. Using objective definitional parameters classifying routine consultations as either effectively or ineffectively made, we measured the scale of ineffective help-seeking. General practitioners categorised consultations as either effective or ineffective. Ineffectively made consultations were categorised as follows: potentially avoidable; made with the wrong healthcare professional; or made at the wrong time.
  
  
  RESULTS
  A total of 22 GPs made 1217 routine consultations for day-to-day symptoms, of which 24% were ineffectively made. Fifteen percent of consultations were potentially avoidable. Potentially avoidable consultations alone may be costing the NHS £87.85 million annually. The ineffective use of limited and scarce healthcare resources should be examined. Patient outcome may be potentially compromised directly by poor help-seeking decisions but also by ineffective use of resources.
authors.affiliation: 1Lecturer and Programme Leader, University of the Highlands and Islands, Lews Castle College UHI, Stornoway, UK.
authors.forename: Gareth
authors.initials: G
authors.lastname: Davies
authors.affiliation: 2Retired: Former institution: Lecturer, Bangor University, School of Sport, Health and Exercise Sciences.
authors.forename: Della
authors.initials: D
authors.lastname: Fazey
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003657:Decision Making; D005260:Female; D058006:General Practice; D019538:Health Care Surveys; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011320:Primary Health Care; D012017:Referral and Consultation; D014852:Wales; D055815:Young Adult