Exploring factors that influence adult presentation to an emergency department in regional Queensland: A linked, cross‐sectional, patient perspective study

• Published in: Emergency medicine Australasia 2019-02, Vol.31 (1), p.67-75
• Main Authors: O'Loughlin, Mary, Harriss, Linton, Thompson, Fintan, McDermott, Robyn, Mills, Jane
• Format: Article
• Language: English
• Subjects: Adult; Aged; attitude to health; chronic disease; Cross-Sectional Studies; Emergency Service, Hospital - organization & administration; Emergency Service, Hospital - statistics & numerical data; Female; health services research; Hospitalization - statistics & numerical data; Humans; Male; Middle Aged; Patient Satisfaction - statistics & numerical data; primary health care; quality of health care; Queensland; Surveys and Questionnaires
• ISSN: 1742-6731; 1742-6723
• DOI: 10.1111/1742-6723.13094

Objective Explore factors that influence presentation at a regional hospital ED and identify opportunities to reduce attendance, particularly for adults with chronic conditions. Methods Cross‐sectional survey of ED attenders, for 1 month period (March to April 2014), with linkage of survey data to administrative data sets. Results A total of 1000 adults completed the survey of which 549 (54.9%) self‐identified as living with a chronic condition. Over half (n = 572, 57.2%) had their presenting problem for less than 24 h prior to attending the ED and 56.8% (n = 568) attended the ED outside working hours. Most ED presentations were recorded in the administrative data set as self‐referred (n = 933, 93.3%); however, 29% (n = 290) of survey participants reported being referred to the ED by a medical practitioner. The majority of adults had a regular general practice (n = 863, 86.3%) with 30% (n = 258) visiting their practice in the week prior to presentation at the ED. Awareness of services such as the 13‐Health telephone advice line was generally low (n = 370, 37%) and most did not consider alternative health services as suitable for their care. High‐quality care, co‐location of diagnostic services and extended hours of service were important to patients. Conclusion Despite being connected to a general practice, people focussed their health‐seeking behaviour on the ED in the immediate period prior to presentation. Patients reported a limited awareness of alternative health services and opportunities exist to potentially reduce ED attendance, particularly for young and middle‐aged adults with chronic conditions.