An analysis of emergency department use by patients with minor illness

Robert Shesser, Thomas Kirsch, Jeff Smith, Robert Hirsch

Research output: Contribution to journalArticle

Abstract

Study objective: To describe the motivation for emergency department use by patients with minor illnesses and compare the demographics and social class characteristics of these patients with those of the general ED population. Design: Observational, case-control study. Setting: Urban ED. Type of participants: A sample group of 325 adult, nongeriatric patients with minor illnesses was selected by screening all patients registering in the ED between 9:00 am and 6:00 pm on 15 randomly selected weekdays. A patient was included in this study group if the chief complaint, method of arrival, and subsequent evaluation met predetermined criteria for minor illness. A comparison group (control) was composed of all ED patients (224) who presented during two randomly selected 24-hour periods that did not overlap with the times of study group enrollment. Interventions: Sample group patients were interviewed concerning their socioeconomic backgrounds, reasons for using the ED, and perceptions of the urgency of their conditions. Comparison group patients' interviews were confined to the collection of demographic and socioeconomic information. Measurements and main results: There were more men (P = .12), more self-pay patients (P = .017), and fewer Medicare patients (P <.001) in the study group. There also was a strong trend toward higher income (P = .059) in the study group. The racial, marital, employment, and educational backgrounds of the two groups were similar. Eighty-two percent of the study group had no chronic illness, and only 36% reported a problem of more than three days' duration. Patients chose to use the ED because of its convenience (23.7%), the absence of previous provider relationships (22.1%), and the inability to make a prompt appointment with their regular provider (19.0%). Major differences existed between the reasons for which different demographic and socioeconomic groups chose ED care. Study group patients believed that less than 24 hours should elapse between the onset of their problem and the time at which they receive medical care. Conclusion: There are no major differences in ED use for minor illness patients from different racial, educational, and economic backgrounds. These patients tend to have a low frequency of chronic illness and often have no established health care provider. They choose the ED for its ease of access and the wide scope of care that can be delivered.

Original languageEnglish (US)
Pages (from-to)743-748
Number of pages6
JournalAnnals of Emergency Medicine
Volume20
Issue number7
DOIs
StatePublished - 1991
Externally publishedYes

Fingerprint

Hospital Emergency Service
Demography
Chronic Disease
Time and Motion Studies
Medicare
Social Class
Health Personnel
Case-Control Studies
Motivation
Appointments and Schedules
Economics
Interviews
Control Groups

Keywords

  • minor illness, emergency department use

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

An analysis of emergency department use by patients with minor illness. / Shesser, Robert; Kirsch, Thomas; Smith, Jeff; Hirsch, Robert.

In: Annals of Emergency Medicine, Vol. 20, No. 7, 1991, p. 743-748.

Research output: Contribution to journalArticle

Shesser, Robert ; Kirsch, Thomas ; Smith, Jeff ; Hirsch, Robert. / An analysis of emergency department use by patients with minor illness. In: Annals of Emergency Medicine. 1991 ; Vol. 20, No. 7. pp. 743-748.
@article{a368b64150b04eec886adc844a99a60f,
title = "An analysis of emergency department use by patients with minor illness",
abstract = "Study objective: To describe the motivation for emergency department use by patients with minor illnesses and compare the demographics and social class characteristics of these patients with those of the general ED population. Design: Observational, case-control study. Setting: Urban ED. Type of participants: A sample group of 325 adult, nongeriatric patients with minor illnesses was selected by screening all patients registering in the ED between 9:00 am and 6:00 pm on 15 randomly selected weekdays. A patient was included in this study group if the chief complaint, method of arrival, and subsequent evaluation met predetermined criteria for minor illness. A comparison group (control) was composed of all ED patients (224) who presented during two randomly selected 24-hour periods that did not overlap with the times of study group enrollment. Interventions: Sample group patients were interviewed concerning their socioeconomic backgrounds, reasons for using the ED, and perceptions of the urgency of their conditions. Comparison group patients' interviews were confined to the collection of demographic and socioeconomic information. Measurements and main results: There were more men (P = .12), more self-pay patients (P = .017), and fewer Medicare patients (P <.001) in the study group. There also was a strong trend toward higher income (P = .059) in the study group. The racial, marital, employment, and educational backgrounds of the two groups were similar. Eighty-two percent of the study group had no chronic illness, and only 36{\%} reported a problem of more than three days' duration. Patients chose to use the ED because of its convenience (23.7{\%}), the absence of previous provider relationships (22.1{\%}), and the inability to make a prompt appointment with their regular provider (19.0{\%}). Major differences existed between the reasons for which different demographic and socioeconomic groups chose ED care. Study group patients believed that less than 24 hours should elapse between the onset of their problem and the time at which they receive medical care. Conclusion: There are no major differences in ED use for minor illness patients from different racial, educational, and economic backgrounds. These patients tend to have a low frequency of chronic illness and often have no established health care provider. They choose the ED for its ease of access and the wide scope of care that can be delivered.",
keywords = "minor illness, emergency department use",
author = "Robert Shesser and Thomas Kirsch and Jeff Smith and Robert Hirsch",
year = "1991",
doi = "10.1016/S0196-0644(05)80835-2",
language = "English (US)",
volume = "20",
pages = "743--748",
journal = "Annals of Emergency Medicine",
issn = "0196-0644",
publisher = "Mosby Inc.",
number = "7",

}

TY - JOUR

T1 - An analysis of emergency department use by patients with minor illness

AU - Shesser, Robert

AU - Kirsch, Thomas

AU - Smith, Jeff

AU - Hirsch, Robert

PY - 1991

Y1 - 1991

N2 - Study objective: To describe the motivation for emergency department use by patients with minor illnesses and compare the demographics and social class characteristics of these patients with those of the general ED population. Design: Observational, case-control study. Setting: Urban ED. Type of participants: A sample group of 325 adult, nongeriatric patients with minor illnesses was selected by screening all patients registering in the ED between 9:00 am and 6:00 pm on 15 randomly selected weekdays. A patient was included in this study group if the chief complaint, method of arrival, and subsequent evaluation met predetermined criteria for minor illness. A comparison group (control) was composed of all ED patients (224) who presented during two randomly selected 24-hour periods that did not overlap with the times of study group enrollment. Interventions: Sample group patients were interviewed concerning their socioeconomic backgrounds, reasons for using the ED, and perceptions of the urgency of their conditions. Comparison group patients' interviews were confined to the collection of demographic and socioeconomic information. Measurements and main results: There were more men (P = .12), more self-pay patients (P = .017), and fewer Medicare patients (P <.001) in the study group. There also was a strong trend toward higher income (P = .059) in the study group. The racial, marital, employment, and educational backgrounds of the two groups were similar. Eighty-two percent of the study group had no chronic illness, and only 36% reported a problem of more than three days' duration. Patients chose to use the ED because of its convenience (23.7%), the absence of previous provider relationships (22.1%), and the inability to make a prompt appointment with their regular provider (19.0%). Major differences existed between the reasons for which different demographic and socioeconomic groups chose ED care. Study group patients believed that less than 24 hours should elapse between the onset of their problem and the time at which they receive medical care. Conclusion: There are no major differences in ED use for minor illness patients from different racial, educational, and economic backgrounds. These patients tend to have a low frequency of chronic illness and often have no established health care provider. They choose the ED for its ease of access and the wide scope of care that can be delivered.

AB - Study objective: To describe the motivation for emergency department use by patients with minor illnesses and compare the demographics and social class characteristics of these patients with those of the general ED population. Design: Observational, case-control study. Setting: Urban ED. Type of participants: A sample group of 325 adult, nongeriatric patients with minor illnesses was selected by screening all patients registering in the ED between 9:00 am and 6:00 pm on 15 randomly selected weekdays. A patient was included in this study group if the chief complaint, method of arrival, and subsequent evaluation met predetermined criteria for minor illness. A comparison group (control) was composed of all ED patients (224) who presented during two randomly selected 24-hour periods that did not overlap with the times of study group enrollment. Interventions: Sample group patients were interviewed concerning their socioeconomic backgrounds, reasons for using the ED, and perceptions of the urgency of their conditions. Comparison group patients' interviews were confined to the collection of demographic and socioeconomic information. Measurements and main results: There were more men (P = .12), more self-pay patients (P = .017), and fewer Medicare patients (P <.001) in the study group. There also was a strong trend toward higher income (P = .059) in the study group. The racial, marital, employment, and educational backgrounds of the two groups were similar. Eighty-two percent of the study group had no chronic illness, and only 36% reported a problem of more than three days' duration. Patients chose to use the ED because of its convenience (23.7%), the absence of previous provider relationships (22.1%), and the inability to make a prompt appointment with their regular provider (19.0%). Major differences existed between the reasons for which different demographic and socioeconomic groups chose ED care. Study group patients believed that less than 24 hours should elapse between the onset of their problem and the time at which they receive medical care. Conclusion: There are no major differences in ED use for minor illness patients from different racial, educational, and economic backgrounds. These patients tend to have a low frequency of chronic illness and often have no established health care provider. They choose the ED for its ease of access and the wide scope of care that can be delivered.

KW - minor illness, emergency department use

UR - http://www.scopus.com/inward/record.url?scp=0025733190&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0025733190&partnerID=8YFLogxK

U2 - 10.1016/S0196-0644(05)80835-2

DO - 10.1016/S0196-0644(05)80835-2

M3 - Article

C2 - 2064094

AN - SCOPUS:0025733190

VL - 20

SP - 743

EP - 748

JO - Annals of Emergency Medicine

JF - Annals of Emergency Medicine

SN - 0196-0644

IS - 7

ER -