Use of an emergency department by nonurgent patients

Objectives: The objectives of this study are (1) to determine whether patients seeking emergency department (ED) nonurgent care have primary care providers (PCP) or know of other care sources and (2) to determine the reasons why they choose to use the ED. Methods: A cross-sectional survey in a university ED was administered to self-referred nonurgent patients for 6 weeks. Use of a PCP, knowledge and attempts to seek other care, past use of the ED, urgency self-report, time of visit, and reasons for choosing an ED were recorded. Results: Of the 563 approached subjects, 314 were eligible and 279 agreed to participate. One hundred fifty-seven (56%) had PCPs. For 183 (66%) subjects, the ED was the only place they knew to go for their present problem, and 75 (27%) reported that they depended on the ED for all medical care. Of those patients with a PCP, 73 (47%) rated the ED better for unscheduled care. Eighty-one (52%) subjects thought their PCP would be more efficient and 66 (42%) thought their PCP would be cheaper. Conclusions: Although most ED nonurgent patients were not dependent upon the ED, the majority was unaware of other places to go for their current health problem. Even those patients with a PCP sought care in the ED because the ED was believed to provide better care despite its perceived increase in both waiting time and cost.