Factors associated with people going to the emergency department for non-urgent visits rather than attending a family physician

Abstract

Context: Poor access to primary care (PC) has been associated with increased use of emergency departments (ED) for non-urgent reasons. Identifying PC factors associated with non-urgent ED use will inform the development of policies designed to lower this usage. Objective: Determine PC factors associated with non-urgent ED use. Design: 1) Canada-wide, and 2) St. John's, NL ED cross-sectional surveys. Participants: 1) Adult PC patients across Canada 2) adult ED patients at Health Sciences Centre, St. John's, NL. Outcome Measures: Patient attended the ED for non-urgent reasons. Results: Limited availability of after-hours services (OR=2.08,p<0.0001) and the ability to arrange an appointment as soon as wanted (OR=0.56,p<0.0001) were significantly associated with non-urgent ED use within the Canada-wide data. Non-urgent St. John’s ED users report that restricted hours of operation influenced them to attend the ED, more than other users (62.5%vs.25.0%, p=0.0083). Conclusions: Limited hours and timely availability of services affect patients’ decisions to attend the ED for non-urgent issues.