Emergency department workload increase: dependence on primary care?

TitleEmergency department workload increase: dependence on primary care?
Publication TypeJournal Article
Year of Publication2010
AuthorsTranquada KE, Denninghoff KR, King ME, Davis SM, Rosen P
JournalJ Emerg Med
Volume38
Issue3
Pagination279-85
Date Published2010 Apr
ISSN Number0736-4679
KeywordsCross-Sectional Studies, Emergency Service, Hospital, Health Care Surveys, Health Services Accessibility, Humans, Primary Health Care, Rural Population, West Virginia, Workload
Abstract

BACKGROUND: Increasing demand for emergency care and crowded emergency departments (EDs) lead some planners to conclude that inconvenient primary care scheduling increases the number of "unnecessary" ED visits. The reasons that the planners argue for more primary care are: to increase funding for primary care; the unfounded notion that it is less expensive to see a primary care physician (PCP) than an Emergency Physician; and the impractical goal that the ED should be used only by intellectually interesting life- or limb-threatened patients or "true emergencies."

OBJECTIVE: To explore the rates of patient-reported access to primary care in ambulatory presentations to a rural tertiary care ED.

METHODS: An observational study was performed in which an anonymous survey was given to a convenience sample of patients who presented by walking into the ED.

RESULTS: Overall, 70.4% (686/975) of respondents stated that they had a PCP, and 38.1 % (252/661) of the sample had attempted to contact their physicians before presenting to the ED. Of the group who attempted to contact their physicians, 62.8% (130) were neither spoken to nor seen by any doctor. These rates did not change by time of presentation or by day of the week.

CONCLUSION: The results suggest that it is neither a lack of primary care, nor the time of day or night that drives patients to come to the ED.

DOI10.1016/j.jemermed.2008.11.031
Alternate JournalJ Emerg Med
PubMed ID19682828
Faculty Reference: 
Kurt Denninghoff, MD