Primary care physician and patient factors that result in patients seeking emergency care in a hospital setting: the patient’s perspective

Inappropriate use of emergency services: a systematic review of prevalence and associated factors

“…In countries with a public health care system, like Brazil, this can be facilitated by continuity in health care, since the primary care team establishes a bond and takes responsibility for the population in its coverage areas and is thus better prepared to provide adequate reception and efficient triage. In parallel, it is important to inform the population on situations in which they really should use the ED and the disadvantages of consulting the ED when the case is not truly urgent 5 . The emergency department, in turn, should develop a counter-referral system to make the tests, diagnoses, and prescriptions performed by the ED available to the other levels of care, in order to improve the care in general and avoid repeating unnecessary tests.…”

“…The inappropriate use of ED services is a common problem in various countries, and the issue has thus been studied for more than two decades 5 . However, the wide range of criteria used to define inappropriate use of ED services has been an obstacle to systematic reviews on the topic 6 .…”

Understanding the causes of overcrowding in emergency departments in the Capital Health Region in Alberta: a focus group study

“…1,2 The phenomenon of ED overcrowding cannot be attributed to any single factor 1 but instead appears to be a product of complex causal relations, encompassing several internal and external factors, 1,3,4 most of which are beyond the control of ED staff. 4 Possible causes include use of the ED for non-emergent cases, 5,6 an aging population, 1 increasing patient acuity, 4 labour shortages, 1,4 lack of community-based alternatives to the ED, 1 delays while waiting for laboratory testing to be completed, 4 lack of public education regarding appropriate ED use and the range of services available in general practitioners' offices, 1,7 lack of long-term care and other alternative settings, 1 and lack of availability of ED or inpatient beds (or both). 1,2,4,[8][9][10][11][12] In contrast to previous studies, which have investigated overcrowding issues within the context of a single ED [1][2][3][4]9,11,12 or addressed specific causes of the problem 8,9,11,[13][14][15] (Predy G, Fraser-Lee N, Gardener K, Edwards J, Brown J, Truman C. Emergency room use for nonurgent medical conditions and the "after hours" accessibility of family physicians in the Capital Health Authority region; unpublished manuscript) we took a systems-based approach, using data from multiple sites within an integrated geographic health region.…”

Utilización por cuenta propia de los Servicios de Urgencias Hospitalarias: razones que dan las personas con problemas de salud de baja complejidad para utilizar estos servicios

“…Aquí parece jugar un papel importante el tiempo de resolución del problema puesto que el paciente, al percibir al CS como una institución con cierto funcionamiento administrativo burocrático, también percibe que la resolución de su problema de salud seguirá este funcionamiento, mediado por los tiempos de espera que implica realizar un determinado procedimiento: tiempo que hay que esperar para realizarlo, para pedir y para que le den nueva hora con el MC para conocer los resultados, para que le den hora en caso dado con el especialista o para un nuevo procedimiento, etc. Es por esto que el hecho de contar con una fuente de atención médica diferente al SUH, como es el caso de España, no reduce de suyo la utilización inadecuada de los SUH como lo señalan varios autores (Burnett, Grover, 1996;Gill, Riley, 1996;Afialo et al, 1995;Boushy, Dubinsky, 1999;Oterino de la Fuente, et al, 2006;Field, Lantz, 2006;Backman, 2008;Rust, et al, 2008) Tanto los resultados de este estudio como su interpretación coinciden con los encontrados por otros autores en el caso de España. Para Alonso, et al (1993) es un hallazgo generalizado el uso excesivo de los SUH por problemas de salud que no justifican tal uso.…”