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Exploring factors that influence adult presentation to an emergency department in regional Queensland: A linked, cross-sectional, patient perspective study
journal contributionposted on 2021-03-03, 03:26 authored by M O'Loughlin, L Harriss, F Thompson, R McDermott, Jane MillsJane Mills
© 2018 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine 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.
This present research was conducted with the support of the Australian Institute of Tropical Health and Medicine (AITHM), Centre for Chronic Disease Prevention, James Cook University, Australia and the Australian Government's Research Training Program Scholarship. The P3ED study was funded by Far North Queensland Medicare Local and the Cairns and Hinterland Hospital and Health Service. Members of the original study team included Professor Jane Mills, A/Professor Kerrianne Watt, Dr Neil Beaton, Dr Michael Wilson, Ms Nicky Neighbour, Dr Scott Davis, Ms Annette Panzera, Dr Richard Stone, Dr Ben Rose, Mr Jarred Brose, Dr Robyn Cant, Mr Murray Towne, Ms Marnie Hitchins, Ms Anna Groth, Dr Don Wyatt, Mr Luke Croker, Mr Vishal Sharma, Ms Amanda Hand and Ms Jane Hollins. The authors thank the patients and staff at the Cairns Hospital for their support of this project.
JournalEMA - Emergency Medicine Australasia
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Science & TechnologyLife Sciences & BiomedicineEmergency Medicineattitude to healthchronic diseasehealth services researchprimary health carequality of health careSERVICESHumansHospitalizationCross-Sectional StudiesAdultAgedMiddle AgedEmergency Service, HospitalPatient SatisfactionQueenslandFemaleMaleSurveys and QuestionnairesEmergency & Critical Care Medicine