title: A day in the life of an urban emergency department.
abstract: OBJECTIVE
  The annual number of patient visits to emergency departments (EDs) continues to increase. Patients seen in the ED for nonemergent conditions potentially increase the cost of health care and lead to overcrowding in EDs.
  
  
  OBJECTIVE
  To gain insights into the factors leading to nonemergent use of hospital EDs.
  
  
  METHODS
  During a 24-hour period, we interviewed 67 patients in an urban ED. A total of 232 patients were seen in the ED and the hospital provided all claims data.
  
  
  METHODS
  None.
  
  
  METHODS
  Elicit and record patient-stated reasons for seeking care in the ED.
  
  
  RESULTS
  Interview results showed that 90% of patients had a primary care clinic although 23% of those clinics were not affiliated with the hospital. Of the 67 interviewed patients, 72% reported they came to the ED because their condition was an emergency, 79% had spoken to someone prior to going to the ED, but only 30% consulted medical personnel.
  
  
  CONCLUSIONS
  Patients did not go to the ED because they lacked a primary care clinic. Most patients did not discuss their condition with medical personnel prior to going to the ED. Informing patients of clinic and hospital affiliations may improve continuity of care and access to electronic health records.
authors.affiliation: Medica Research Institute, Minnetonka, MN, USA ann.curoe@medica.com.
authors.forename: Ann
authors.initials: A
authors.lastname: Curoe
authors.affiliation: Medica Research Institute, Minnetonka, MN, USA.
authors.forename: John
authors.initials: J
authors.lastname: Kralewski
authors.affiliation: Medica Research Institute, Minnetonka, MN, USA.
authors.forename: Megan
authors.initials: M
authors.lastname: Savage
authors.affiliation: Medica Research Institute, Minnetonka, MN, USA.
authors.forename: Beth
authors.initials: B
authors.lastname: Lindholm
mesh_terms: D000328:Adult; D000368:Aged; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006300:Health Services Misuse / Q000706:statistics & numerical data*; D006786:Hospitals, Urban / Q000706:statistics & numerical data; D006801:Humans; D007348:Insurance, Health; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: access to care; emergency visits; managed care; patient-centeredness; primary care