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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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    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.
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