title: Public use and perceptions of emergency departments: A population survey.
abstract: OBJECTIVE
  To inform demand management strategies aimed at reducing congestion in EDs by: (i) identifying public use of EDs, decision-making and reasons; and (ii) measuring acceptance of alternative care models.
  
  
  METHODS
  A cross-sectional telephone survey of a random sample of Queensland population aged 18 years or older residing in a dwelling unit in Queensland that could be contacted on a land-based telephone service was conducted. One person per household was selected according to a predetermined algorithm to ensure sex and regional balance were interviewed. The main outcome measures were: ED use, attitudes towards ED staff and services, and alternative models of care.
  
  
  RESULTS
  The final sample included a total of 1256 respondents (response rate = 40.3%). Twenty-one per cent attended EDs in the preceding 12 months. The decision to attend was made by patients (51%), health and medical professionals (31%), and others (18%). The main reasons included perceived severity of the illness (47%), unavailability of alternative services (26%) and better care (11%). Most respondents agreed with more flexible care models of service delivery including incentives for general practitioners (90%), private health insurance coverage for ED use (89%), and enhanced roles for paramedics and nurses.
  
  
  CONCLUSIONS
  Main reason for attending ED is perceived severity of illness, followed by lack of alternative care. The majority of both consumers and the public are in favour of more flexible care models. However, further research is necessary to detail those alternatives and to test and validate their effectiveness.
authors.affiliation: School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia.
authors.forename: Gerry
authors.initials: G
authors.lastname: FitzGerald
authors.affiliation: School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia.
authors.forename: Ghasem Sam
authors.initials: GS
authors.lastname: Toloo
authors.affiliation: College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Aitken
authors.affiliation: Department of Emergency Medicine, Gold Coast Health Service District, Gold Coast, Queensland, Australia.|Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia.|School of Medicine, Griffith University, Gold Coast, Queensland, Australia.|Queensland Emergency Research Collaborative, Queensland Emergency Medicine Research Foundation, Brisbane, Queensland, Australia.
authors.forename: Gerben
authors.initials: G
authors.lastname: Keijzers
authors.affiliation: Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Scuffham
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000458:organization & administration / Q000592:standards; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D017060:Patient Satisfaction; D011793:Queensland; D014600:Utilization Review; D055815:Young Adult
keywords: demand; emergency department; model of care; population survey; public perspective