Exploring factors that influence adult presentation to an emergency department in regional Queensland: A linked, cross-sectional, patient perspective study
Date
2019
Authors
O'Loughlin, M.
Harriss, L.
Thompson, F.
McDermott, R.
Mills, J.
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Journal article
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EMA - Emergency Medicine Australasia, 2019; 31(1):67-75
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Abstract
Objective: Explore factors that influence presentation at a regional hospital ED and identify opportunities to reduce attendance, particularly for adults with chronic conditions. Methods: Cross-sectional survey of ED attenders, for 1 month period (March to April 2014), with linkage of survey data to administrative data sets. Results: A total of 1000 adults completed the survey of which 549 (54.9%) self-identified as living with a chronic condition. Over half (n=572, 57.2%) had their presenting problem for less than 24h prior to attending the ED and 56.8% (n=568) attended the ED outside working hours. Most ED presentations were recorded in the administrative data set as self-referred (n=933, 93.3%); however, 29% (n=290) of survey participants reported being referred to the ED by a medical practitioner. The majority of adults had a regular general practice (n=863, 86.3%) with 30% (n=258) visiting their practice in the week prior to presentation at the ED. Awareness of services such as the 13-Health telephone advice line was generally low (n=370, 37%) and most did not consider alternative health services as suitable for their care. High-quality care, co-location of diagnostic services and extended hours of service were important to patients. Conclusion: Despite being connected to a general practice, people focussed their health-seeking behaviour on the ED in the immediate period prior to presentation. Patients reported a limited awareness of alternative health services and opportunities exist to potentially reduce ED attendance, particularly for young and middle-aged adults with chronic conditions
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Copyright 2018 Australasian College for Emergency Medicine & Australasian Society for Emergency Medicine.