Ambulance Use Is Associated With Higher Self‐rated Illness Seriousness: User Attitudes and Perceptions

• Published in: Academic emergency medicine 2013-06, Vol.20 (6), p.576-583
• Main Authors: Toloo, Ghasem (Sam), FitzGerald, Gerry J., Aitken, Peter J., Ting, Joseph Y. S., McKenzie, Kirsten, Rego, Joanna, Enraght‐Moony, Emma, Shah, Manish
• Format: Article
• Language: English
• Subjects: Adult; Ambulance services; Ambulances - utilization; Attitude to Health; Attitudes; Cross-Sectional Studies; Emergency medical care; Emergency Medical Services - utilization; Female; Health Knowledge, Attitudes, Practice; Humans; Male; Patients; Perceptions; Queensland; Self Report; Severity of Illness Index; Surveys and Questionnaires; Utilization Review; Wellness programs
• ISSN: 1069-6563; 1553-2712
• DOI: 10.1111/acem.12149

Objectives The objective was to study the role and effect of patients' perceptions on reasons for using ambulance services in Queensland, Australia. Methods A cross‐sectional survey was conducted of patients (n = 911) presenting via ambulance or self‐transport at eight public hospital emergency departments (EDs). The survey included perceived illness severity, attitudes toward ambulance, and reasons for using ambulance. A theoretical framework was developed to inform this study. Results Ambulance users had significantly higher self‐rated perceived seriousness, urgency, and pain than self‐transports. They were also more likely to agree that ambulance services are for everyone to use, regardless of the severity of their conditions. In compared to self‐transports, likelihood of using an ambulance increased by 26% for every unit increase in perceived seriousness; and patients who had not used an ambulance in the 6 months prior to the survey were 66% less likely to arrive by ambulance. Patients who had presented via ambulance stated they considered the urgency (87%) or severity (84%) of their conditions as reasons for calling the ambulance. Other reasons included requiring special care (76%), getting higher priority at the ED (34%), not having a car (34%), and financial concerns (17%). Conclusions Understanding patients' perceptions is essential in explaining their actions and developing safe and effective health promotion programs. Individuals use ambulances for various reasons and justifications according to their beliefs, attitudes, and sociodemographic conditions. Policies to reduce and manage demand for such services need to address both general opinions and specific attitudes toward emergency health services to be effective. Resumen El Uso de la Ambulancia Se Asocia con una Mayor Autopercepción de Gravedad de las Enfermedades: Actitudes y Percepciones del Usuario Objetivos Estudiar el papel y el impacto de las percepciones de los pacientes en las razones para el uso de los servicios de ambulancias en Queensland, Australia. Metodología Se realizó una encuesta transversal a los pacientes (n = 911) que acudieron mediante ambulancia o por sus propios medios en ocho servicios de urgencias (SU) de hospitales públicos. La encuesta incluyó la percepción de la gravedad de la enfermedad, las actitudes hacia la ambulancia y las razones para el uso de ambulancia. Se desarrolló un marco teórico para informar este estudio. Resultados Los usuarios de ambulancias tuviero