IDEAS home Printed from https://ideas.repec.org/a/eee/hepoli/v88y2008i2-3p326-338.html
   My bibliography  Save this article

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

Author

Listed:
  • 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.

Suggested Citation

  • 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
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0168-8510(08)00098-5
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    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. 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.
    4. 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.
    5. 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.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. 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.
    2. 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.
    3. Schmidt, Henrike & Wild, Eva-Maria & Schreyögg, Jonas, 2021. "Explaining variation in health information seeking behaviour – Insights from a multilingual survey," Health Policy, Elsevier, vol. 125(5), pages 618-626.
    4. 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.
    5. Hong, Michael & Thind, Amardeep & Zaric, Gregory S. & Sarma, Sisira, 2020. "The impact of improved access to after-hours primary care on emergency department and primary care utilization: A systematic review," Health Policy, Elsevier, vol. 124(8), pages 812-818.
    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. 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.
    8. 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.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Gansel, Yannis & Danet, François & Rauscher, Catherine, 2010. "Long-stay inpatients in short-term emergency units in France: A case study," Social Science & Medicine, Elsevier, vol. 70(4), pages 501-508, February.
    2. Nerina Vecchio & Nicholas Rohde, 2017. "The effect of inadequate access to healthcare services on emergency room visits in Australia," Discussion Papers in Economics economics:201708, Griffith University, Department of Accounting, Finance and Economics.
    3. Smith, Samantha, 2007. "Emergency Department Utilisation in Four Irish Teaching Hospitals," Papers HRBWP26, Economic and Social Research Institute (ESRI).
    4. Corinne Blöchliger & Joseph Osterwalder & Christoph Hatz & Marcel Tanner & Thomas Junghanss, 1998. "Asylsuchende und Flüchtlinge in der Notfallstation," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 43(1), pages 39-48, January.
    5. 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.
    6. Christian T. Braun & Cornelia R. Gnägi & Jolanta Klukowska-Rötzler & Sufian S. Ahmad & Meret E. Ricklin & Aristomenis K. Exadaktylos, 2017. "Trends and Weekly Cycles in a Large Swiss Emergency Centre: A 10 Year Period at the University Hospital of Bern," IJERPH, MDPI, vol. 14(10), pages 1-12, October.
    7. Refael Hassin & Ricky Roet-Green, 2017. "The Impact of Inspection Cost on Equilibrium, Revenue, and Social Welfare in a Single-Server Queue," Operations Research, INFORMS, vol. 65(3), pages 804-820, June.
    8. Broekman, S.M. & Gils- van Rooij, E.S.J. & Meijboom, B.R. & Yzermans, C.J., 2017. "Do out-of-hours GP services and emergency departments cost more by collaborating, or by working separately? : A cost analysis," Other publications TiSEM e313955c-a62e-4b27-b0ee-b, Tilburg University, School of Economics and Management.
    9. Man Jiang & Guang Yang & Lvying Fang & Jin Wan & Yinghua Yang & Ying Wang, 2018. "Factors associated with healthcare utilization among community-dwelling elderly in Shanghai, China," PLOS ONE, Public Library of Science, vol. 13(12), pages 1-22, December.
    10. Salhi, Bisan A., 2020. "Who are Clive's friends? Latent sociality in the emergency department," Social Science & Medicine, Elsevier, vol. 245(C).
    11. Veazie, Peter & Denham, Alina, 2021. "Understanding how psychosocial factors relate to seeking medical care among older adults using a new model of care seeking," Social Science & Medicine, Elsevier, vol. 281(C).
    12. Hélène Colineaux & Fanny Le Querrec & Laure Pourcel & Jean-Christophe Gallart & Olivier Azéma & Thierry Lang & Michelle Kelly-Irving & Sandrine Charpentier & Sébastien Lamy, 2018. "Is the use of emergency departments socially patterned?," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 63(3), pages 397-407, April.
    13. Genevieve E O'Connor, 2016. "Investigating the significance of insurance and income on health service utilization across generational cohorts," Journal of Financial Services Marketing, Palgrave Macmillan, vol. 21(1), pages 19-33, March.
    14. Roberts, Emilie & Mays, Nicholas, 1998. "Can primary care and community-based models of emergency care substitute for the hospital accident and emergency (A & E) department?," Health Policy, Elsevier, vol. 44(3), pages 191-214, June.
    15. de Boer, Angela G. E. M. & Wijker, Wouter & de Haes, Hanneke C. J. M., 1997. "Predictors of health care utilization in the chronically ill: a review of the literature," Health Policy, Elsevier, vol. 42(2), pages 101-115, November.
    16. Lee, Albert & Hazlett, Clarke B. & Chow, S. & Lau, Fei-lung & Kam, Chak-wah & Wong, Patrick & Wong, Tai-wai, 2003. "How to minimize inappropriate utilization of Accident and Emergency Departments: improve the validity of classifying the general practice cases amongst the A&E attendees," Health Policy, Elsevier, vol. 66(2), pages 159-168, November.
    17. Neil, Amanda L. & Chappell, Kate & Wagg, Fiona & Miller, April & Judd, Fiona, 2021. "The Tasmanian Conception to Community (C2C) Study Database 2008-09 to 2013-14: Using linked health administrative data to address each piece in the puzzle," Social Science & Medicine, Elsevier, vol. 284(C).
    18. Gavin M Rudge & Mohammed A Mohammed & Sally C Fillingham & Alan Girling & Khesh Sidhu & Andrew J Stevens, 2013. "The Combined Influence of Distance and Neighbourhood Deprivation on Emergency Department Attendance in a Large English Population: A Retrospective Database Study," PLOS ONE, Public Library of Science, vol. 8(7), pages 1-8, July.
    19. Wellstood, Katie & Wilson, Kathi & Eyles, John, 2005. ""Unless you went in with your head under your arm": Patient perceptions of emergency room visits," Social Science & Medicine, Elsevier, vol. 61(11), pages 2363-2373, December.
    20. Eiman Jahangir & Vilma Irazola & Adolfo Rubinstein, 2012. "Need, Enabling, Predisposing, and Behavioral Determinants of Access to Preventative Care in Argentina: Analysis of the National Survey of Risk Factors," PLOS ONE, Public Library of Science, vol. 7(9), pages 1-6, September.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:hepoli:v:88:y:2008:i:2-3:p:326-338. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu or the person in charge (email available below). General contact details of provider: http://www.elsevier.com/locate/healthpol .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.