Why Patients Attend Emergency Departments

Why Patients Attend Emergency Departments for Primary Health Care Type Problems

CPD Hours: 1
Current as at 06 June 2022
Many patients believe that the emergency department (ED) is the best place for them to receive care and are uncertain about using a primary care alternative. There are various reasons for this, nevertheless, emergency department visits for low-acuity or non-urgent issues make up 25% to 30% of ED visits across developed countries.

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Discuss what contributes to patients over utilising EDs for primary health care-type presentations

Course Content

Many patients believe that the emergency department (ED) is the best place for them to receive care and are uncertain about using a primary care alternative. There are various reasons for this, nevertheless, emergency department visits for low-acuity or non-urgent issues make up 25% to 30% of ED visits across developed countries. Older people, for example, are more likely than younger people to have multiple ED presentations, and this rate has doubled within a decade. The increased rate of re-presentations, coupled with the projected increase in the proportion of older people in Australia, creates an imperative to improve the management of this complex issue. Some older people who are frequent users of unplanned acute care may not receive care that meets their needs, resulting in fragmented care and increased healthcare utilisation.

Previous research has suggested that patients present to the ED for low-acuity issues for many reasons, including perceiving their issues as very urgent, trust in the hospital, the proximity of the hospital to their home, the expediency of being seen by a doctor, and referral from another physician to the ED. In Australia, the frequency of ED visits for low-acuity issues has been found to be higher in populations that have lower socioeconomic status, and have no regular primary health care provider. This study adds to the limited literature examining reasons why people present to the ED with low-acuity issues. Despite a general assumption among health care providers that many low-acuity ED presentations could be adequately treated in a primary care setting, most ED patients, on the other hand, believe that the ED is the best place for them.

There has been much effort to address this problem with integrated care initiatives, but the evidence is mixed about what approaches are most effective and there are no simple ‘one size fits all solutions. There is a need to understand the issues in a local context before attempting to design and implement solutions to address fragmented care, hence the reason for the study reported in this paper.

Learning Outcomes

In this session, you will:

  • Discuss what contributes to patients over utilising EDs for primary health care-type presentations
  • Explore what could lead the patients not to seek GP help instead of attending ED
  • Learn about the health care providers’ perspective in the ED, private general practices and an ACCHO
  • Increase your understanding of how patients perceive their own need to present to ED with a primary care type problem

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