Why do people seek emergency or urgent care? This quick systematic review of the literature identified the following reasons.
- limited access to or confidence in primary care
- patient perceived urgency
- views of family, friends, or other health professionals
- belief that their condition required the resources and facilities offered by a particular healthcare provider.
Why does this matter?
ED overcrowding is a well documented fact in the US and internationally. As more people seek care in ED or urgent care settings, we have to ask why, especially for lower acuity conditions. This literature review sheds light on answers to that question. This, in turn, can lead to policy decisions that can affect patient decision-making. Simple, right? At least it's a good start.
So...why are you here with your stubbed toe?
This was a quick literature review, not a full systematic review of the literature on why patients seek emergency or urgent care. Most studies were from the US and UK. They did a narrative review of the major themes from 38 papers. The themes are listed above. The answer to most of these problems is a concerted effort on the part of payors, hospitals, and government entities to educate patients, the public, and healthcare providers on what are the appropriate venues for care. Also, until we in the US are able to meet lower acuity patients at the door and inform them that they must seek care elsewhere or that they are being placed in a low acuity cue with prolonged wait times until higher acuity patients are seen first, I don't think we can make a meaningful impact on this problem. We can't fault fearful patients for coming, but we can help them make better decisions. Healthcare providers need education too but are more culpable when they make inappropriate referrals for emergency care.
Why Do People Choose Emergency and Urgent Care Services? A Rapid Review Utilizing a Systematic Literature Search and Narrative Synthesis. Acad Emerg Med. 2017 Sep;24(9):1137-1149. doi: 10.1111/acem.13220. Epub 2017 Jun 19.
Peer reviewed by Thomas Davis, MD.