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Why non-urgent patients choose emergency over primary care services? Empirical evidence and managerial implications

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  • Lega, Federico
  • Mengoni, Alessandro

Abstract

Objective To investigate structural and psychological factors that lead non-urgent patients to choose the Accidents & Emergency Department (A&ED) rather than primary care services.Data sources Data were collected through interviews by means of a structured questionnaire. Data regarding the A&ED sample were also drawn from the database of the department.Study design Hypotheses were tested in a survey comparing A&ED non-urgent patients and patients using GP surgeries. Different perceptions of the characteristics of A&ED and primary care services were measured and a perceptual map was created using the linear discriminant analysis (LDA).Data collection Emergency services users were interviewed in the A&ED of the General Hospital of the Province of Macerata (Italy). Primary care users were interviewed in four GP surgeries. 527 patients were interviewed between December 2006 and February 2007.Principal findings A&ED and primary care patients look for different characteristics as diagnostic and therapeutic potentialities, empathy and competence, quick access or long-lasting relationship. Information asymmetry explains part of the behaviour.Conclusions Use of A&ED services for non-urgent care can be reduced. The understanding of reasons underlying the choice and a change in access, timing and contents of care/services provided by general practitioners (GPs) might provide incentives for shifting from A&ED to GPs surgeries.

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  • Lega, Federico & Mengoni, Alessandro, 2008. "Why non-urgent patients choose emergency over primary care services? Empirical evidence and managerial implications," Health Policy, Elsevier, vol. 88(2-3), pages 326-338, December.
    • Handle: RePEc:eee:hepoli:v:88:y:2008:i:2-3:p:326-338
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    1. Padgett, Deborah K. & Brodsky, Beth, 1992. "Psychosocial factors influencing non-urgent use of the emergency room: A review of the literature and recommendations for research and improved service delivery," Social Science & Medicine, Elsevier, vol. 35(9), pages 1189-1197, November.
    2. Béland, François & Lemay, Anne & Boucher, Marcel, 1998. "Patterns of visits to hospital-based emergency rooms," Social Science & Medicine, Elsevier, vol. 47(2), pages 165-179, July.
    3. Shah, Nasra M. & Shah, Makhdoom A. & Jaafar, Behbehani, 1996. "Predictors of non-urgent utilization of hospital emergency services in Kuwait," Social Science & Medicine, Elsevier, vol. 42(9), pages 1313-1323, May.
    4. Lee, Albert & Lau, Fei-Lung & Hazlett, Clarke B. & Kam, Chak-Wah & Wong, Patrick & Wong, Tai-Wai & Chow, Susan, 2000. "Factors associated with non-urgent utilization of Accident and Emergency services: a case-control study in Hong Kong," Social Science & Medicine, Elsevier, vol. 51(7), pages 1075-1085, October.
    5. Green, Judith & Dale, Jeremy, 1992. "Primary care in accident and emergency and general practice: A comparison," Social Science & Medicine, Elsevier, vol. 35(8), pages 987-995, October.
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    3. Donatini A. & Fiorentini G. & Lippi Bruni M. & Mammi I. & Ugolini C., 2014. "Dealing with minor illnesses: the link between primary care characteristics and First Aid Clinics attendances," Working Papers wp925, Dipartimento Scienze Economiche, Universita' di Bologna.
    4. Chan, Chien-Lung & Lin, Wender & Yang, Nan-Ping & Huang, Hsin-Tsung, 2013. "The association between the availability of ambulatory care and non-emergency treatment in emergency medicine departments: A comprehensive and nationwide validation," Health Policy, Elsevier, vol. 110(2), pages 271-279.
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    6. Fatih Santas & Ahmet Kar & Gulcan Kahraman & Arzu Kursun, 2016. "Perceptual Maps: An Empirical Research on Hospitals," Proceedings of International Academic Conferences 4006535, International Institute of Social and Economic Sciences.
    7. Behrens, Doris A. & Morgan, Jennifer S. & Krczal, Eva & Harper, Paul R. & Gartner, Daniel, 2023. "Still looking in the wrong place: Literature-based evidence of why patients really attend an emergency department," Socio-Economic Planning Sciences, Elsevier, vol. 90(C).
    8. Andrea Francesconi & Massimo Amato, 2015. "Risvolti aziendali e di sistema della regolamentazione degli accessi non urgenti nei Dipartimenti di Emergenza-Urgenza: l?esperienza dell?Azienda Ospedaliera "Spedali Civili" di Brescia," MECOSAN, FrancoAngeli Editore, vol. 2015(94), pages 97-113.
    9. Lippi Bruni, Matteo & Mammi, Irene & Ugolini, Cristina, 2016. "Does the extension of primary care practice opening hours reduce the use of emergency services?," Journal of Health Economics, Elsevier, vol. 50(C), pages 144-155.
    10. Ugolini, Cristina & Lippi Bruni, Matteo & Mammi, Irene & Donatini, Andrea & Fiorentini, Gianluca, 2016. "Dealing with minor illnesses: The link between primary care characteristics and Walk-in Centres’ attendances," Health Policy, Elsevier, vol. 120(1), pages 72-80.

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