Reasons for attending an urban urgent care centre with minor illness: a questionnaire study

Amiel, Cressida; Williams, Bronwen; Ramzan, Farzan; Islam, Saiful; Ladbrooke, Tim; Majeed, Azeem; Gnani, Shamini

doi:10.1136/emermed-2012-202016

Cited by 36 publications

(40 citation statements)

References 15 publications

(13 reference statements)

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“…Another factor was lack of awareness of other services, with one study reporting that seven of 30 patients who attended ED had no knowledge of alternative primary care options 38. GP dissatisfaction influenced 10% of patients in their decision to attend an urgent care center39 and in some cases high rates of PCP dissatisfaction was reported 45. One study reported that patients felt that out‐of‐hours care was impersonal 46…”

Section: Resultsmentioning

confidence: 99%

Why Do People Choose Emergency and Urgent Care Services? A Rapid Review Utilizing a Systematic Literature Search and Narrative Synthesis

Coster

Turner

Bradbury

et al. 2017

Academic Emergency Medicine

248

217

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ObjectivesRising demand for emergency and urgent care services is well documented, as are the consequences, for example, emergency department (ED) crowding, increased costs, pressure on services, and waiting times. Multiple factors have been suggested to explain why demand is increasing, including an aging population, rising number of people with multiple chronic conditions, and behavioral changes relating to how people choose to access health services. The aim of this systematic mapping review was to bring together published research from urgent and emergency care settings to identify drivers that underpin patient decisions to access urgent and emergency care.MethodsSystematic searches were conducted across Medline (via Ovid SP), EMBASE (via Ovid), The Cochrane Library (via Wiley Online Library), Web of Science (via the Web of Knowledge), and the Cumulative Index to Nursing and Allied Health Literature (CINAHL; via EBSCOhost). Peer‐reviewed studies written in English that reported reasons for accessing or choosing emergency or urgent care services and were published between 1995 and 2016 were included. Data were extracted and reasons for choosing emergency and urgent care were identified and mapped. Thematic analysis was used to identify themes and findings were reported qualitatively using framework‐based narrative synthesis.ResultsThirty‐eight studies were identified that met the inclusion criteria. Most studies were set in the United Kingdom (39.4%) or the United States (34.2%) and reported results relating to ED (68.4%). Thirty‐nine percent of studies utilized qualitative or mixed research designs. Our thematic analysis identified six broad themes that summarized reasons why patients chose to access ED or urgent care. These were access to and confidence in primary care; perceived urgency, anxiety, and the value of reassurance from emergency‐based services; views of family, friends, or healthcare professionals; convenience (location, not having to make appointment, and opening hours); individual patient factors (e.g., cost); and perceived need for emergency medical services or hospital care, treatment, or investigations.ConclusionsWe identified six distinct reasons explaining why patients choose to access emergency and urgent care services: limited access to or confidence in primary care; patient perceived urgency; convenience; views of family, friends, or other health professionals; and a belief that their condition required the resources and facilities offered by a particular healthcare provider. There is a need to examine demand from a whole system perspective to gain better understanding of demand for different parts of the emergency and urgent care system and the characteristics of patients within each sector.

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Section: Resultsmentioning

confidence: 99%

Why Do People Choose Emergency and Urgent Care Services? A Rapid Review Utilizing a Systematic Literature Search and Narrative Synthesis

Coster

Turner

Bradbury

et al. 2017

Academic Emergency Medicine

248

217

View full text Add to dashboard Cite

show abstract

“…For example, in a survey of 1886 patients attending 20 walk-in centres throughout England, 22% of responders registered to a general practice elsewhere had tried but were unable to obtain a convenient general practice appointment 16. At an urgent care centre co-located with an emergency department in London, England, 20% of surveyed patients attending with ‘minor illness’ had been unable to obtain a timely general practice appointment;17 58% of patients had stated that one reason for their attendance was that it was ‘quicker than getting a GP appointment’,17 and the large majority of all attendees could have been managed by a GP or emergency nurse practitioner 18. A GP panel review of a random sample of 629 clinical case notes from patients attending an emergency department in Oxford, England, concluded that approximately 43% of patients could have been managed by a GP 19.…”

Section: Discussionmentioning

confidence: 99%

Access to general practice and visits to accident and emergency departments in England: cross-sectional analysis of a national patient survey

et al. 2014

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BackgroundThe annual number of unplanned attendances at accident and emergency (A&E) departments in England increased by 11% (2.2 million attendances) between 2008–2009 and 2012–2013. A national review of urgent and emergency care has emphasised the role of access to primary care services in preventing A&E attendances.AimTo estimate the number of A&E attendances in England in 2012–2013 that were preceded by the attending patient being unable to obtain an appointment or a convenient appointment at their general practice.Design and settingCross-sectional analysis of a national survey of adults registered with a GP in England.MethodThe number of general practice consultations in England in 2012–2013 was estimated by extrapolating the linear trend of published data for 2000–2001 to 2008–2009. This parameter was multiplied by the ratio of attempts to obtain a general practice appointment that resulted in an A&E attendance to attempts that resulted in a general practice consultation estimated using the GP Patient Survey 2012–2013. A sensitivity analysis varied the number of consultations by ±12% and the ratio by ±25%.ResultsAn estimated 5.77 million (99.9% confidence interval = 5.49 to 6.05 million) A&E attendances were preceded by the attending patient being unable to obtain a general practice appointment or a convenient appointment, comprising 26.5% of unplanned A&E attendances in England in 2012–2013. The sensitivity analysis produced values between 17.5% and 37.2% of unplanned A&E attendances.ConclusionA large number of A&E attendances are likely to be preceded by unsuccessful attempts to obtain convenient general practice appointments in England each year.

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“…The number of EDs visit is on the increase, and the pressure on EDs is of significant concern worldwide 1. The usage of EDs by patients with minor illness is an important and still unresolved problem, which places significant burden on healthcare services,2 increases waiting times in the ED3 and is of significant concern to ED staff, ED directors and policy makers 4…”

Section: Introductionmentioning

confidence: 99%

Exploring parents’ reasons for attending the emergency department for children with minor illnesses: a mixed methods systematic review

et al. 2018

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BackgroundThe number of EDs visit is on the increase, and the pressure on EDs is of significant concern worldwide. The usage of EDs by parents of children with minor illness is an important and still unresolved problem causing a burden to healthcare services. The aim of this study was to review the literature to summarise parental reasons for visiting ED for children with minor illness.MethodSeven electronic databases (Medline, Embase, PsycINFO, CINAHL, PubMed, Web of Science and Scopus) were comprehensively searched during a 2-week period in August 2016 and updated between 11 and 20 June 2018. The study selection process was undertaken independently by two authors. Qualitative and quantitative studies that focused on the reasons for parents of children with minor illness to attend an ED were included. Studies were assessed for quality and data were analysed by means of narrative synthesis.ResultsTwenty-four studies were included. Eleven studies employed quantitative methods, eleven studies used qualitative methods and two studies used mixed methods. Parental reasons for using ED included perceived urgency, ED advantages (eg, faster service, superior ED resources and efficiency), difficulties with getting a general practitioner appointment, lack of facilities in primary healthcare services, lack of health insurance, reassurance, convenience and access.ConclusionThis review identified some of the reasons why parents bring their children to the ED for minor illnesses highlighting the multifaceted nature of this problem. Understanding parental reasons behind their choice to use the ED may help us better design targeted interventions to reduce unnecessary ED visits and alleviate the burden on overstretched healthcare services. This review may help inform emergency care policy makers, researchers and healthcare staff to understand parents’ reasons for visiting the ED, to better meet their healthcare needs.

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Reasons for attending an urban urgent care centre with minor illness: a questionnaire study

Cited by 36 publications

References 15 publications

Why Do People Choose Emergency and Urgent Care Services? A Rapid Review Utilizing a Systematic Literature Search and Narrative Synthesis

Why Do People Choose Emergency and Urgent Care Services? A Rapid Review Utilizing a Systematic Literature Search and Narrative Synthesis

Access to general practice and visits to accident and emergency departments in England: cross-sectional analysis of a national patient survey

Exploring parents’ reasons for attending the emergency department for children with minor illnesses: a mixed methods systematic review

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