Motivations for Seeking Emergency Department Care Among Rural and Urban Patients

2.50
Hdl Handle:
http://hdl.handle.net/10755/198344
Title:
Motivations for Seeking Emergency Department Care Among Rural and Urban Patients
Abstract:
[ENA Annual Conference 2011 - Research Presentation]Motivations for Seeking Emergency Department Care among Rural and Urban Patients

Purpose: People living in rural areas often bypass local health care options, presenting to larger hospitals far from home for care. Further, often people present to the ED with non-emergent chronic health needs that could be well served by a primary care provider, such as requests for medication refills, urinary tract infections or mild nausea due to gastroparesis. This use of EDs for non emergent presentations has soared. The purpose of this study was to determine, from the consumer’s perspective, issues related to accessing health care and rationale for presenting to a non-rural emergency department for health care.
Design and Setting: This pilot study was a mixed-methods descriptive examination of the experiences of those seeking health care in a non-rural ED in the Southeastern United States.

Participants/Subjects: This study utilized a convenience sample of 50 men and women presenting to the ED. Participants had to be a patient or immediate family member, able to speak and write English, age 18 or older, not in obvious significant pain or incapacitated by medical illness, and not presenting with altered mental status, unresponsiveness, intoxication or combativeness. Participants were excluded if they were children, in obvious significant pain, incapacitated by medical illness, or if they presented with altered mental status, unresponsiveness, intoxication or combativeness. This study received IRB approval.

Methods: Participants who volunteered to be in the study were given a brief questionnaire to complete or had the short survey form read to them. This survey collected data such as gender, zip code, chief complaint, age, insurance type, and number of ED visits over the past year. Qualitative data was collected by in-person interviews after the survey form was completed. Lastly, data regarding triage level, whether the patient was admitted or not, and admitting diagnosis was collected from patient charts.

Results/Outcomes: Four themes were identified: Health status, Relationship with primary health care provider, Access to care and Reasons for choosing this facility, specifically the ED.
Barriers to accessing healthcare included cost, lack of insurance, lack of a primary care provider, lack of transportation, and the time involved to access care. Challenges for patients included obtaining an appointment for follow-up after being seen in an ED, the lack of PCPs in their home area, difficulty seeing the same doctor more than once outside the hospital and the lack of accessible mental health services.

Implications: This pilot study examines, from the patients’ perspectives, why both rural and urban residents seek medical care in an ED. The aim of the study was to gain a better understanding of issues related to accessing health care and the rationale for persons presenting to a non-rural emergency department for health care. The ED continues to be a safety net for patients who have difficulty accessing the health care system. The identified barriers provide opportunities for healthcare system improvements, healthcare provider education, public education and continued research to ultimately improve access to care outside of the ED setting.


Repository Posting Date:
21-Dec-2011
Date of Publication:
21-Dec-2011

Full metadata record

DC FieldValue Language
dc.titleMotivations for Seeking Emergency Department Care Among Rural and Urban Patientsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/198344-
dc.description.abstract[ENA Annual Conference 2011 - Research Presentation]Motivations for Seeking Emergency Department Care among Rural and Urban Patients<br/><br/>Purpose: People living in rural areas often bypass local health care options, presenting to larger hospitals far from home for care. Further, often people present to the ED with non-emergent chronic health needs that could be well served by a primary care provider, such as requests for medication refills, urinary tract infections or mild nausea due to gastroparesis. This use of EDs for non emergent presentations has soared. The purpose of this study was to determine, from the consumer’s perspective, issues related to accessing health care and rationale for presenting to a non-rural emergency department for health care. <br/>Design and Setting: This pilot study was a mixed-methods descriptive examination of the experiences of those seeking health care in a non-rural ED in the Southeastern United States. <br/><br/>Participants/Subjects: This study utilized a convenience sample of 50 men and women presenting to the ED. Participants had to be a patient or immediate family member, able to speak and write English, age 18 or older, not in obvious significant pain or incapacitated by medical illness, and not presenting with altered mental status, unresponsiveness, intoxication or combativeness. Participants were excluded if they were children, in obvious significant pain, incapacitated by medical illness, or if they presented with altered mental status, unresponsiveness, intoxication or combativeness. This study received IRB approval.<br/><br/>Methods: Participants who volunteered to be in the study were given a brief questionnaire to complete or had the short survey form read to them. This survey collected data such as gender, zip code, chief complaint, age, insurance type, and number of ED visits over the past year. Qualitative data was collected by in-person interviews after the survey form was completed. Lastly, data regarding triage level, whether the patient was admitted or not, and admitting diagnosis was collected from patient charts. <br/><br/>Results/Outcomes: Four themes were identified: Health status, Relationship with primary health care provider, Access to care and Reasons for choosing this facility, specifically the ED. <br/>Barriers to accessing healthcare included cost, lack of insurance, lack of a primary care provider, lack of transportation, and the time involved to access care. Challenges for patients included obtaining an appointment for follow-up after being seen in an ED, the lack of PCPs in their home area, difficulty seeing the same doctor more than once outside the hospital and the lack of accessible mental health services. <br/><br/>Implications: This pilot study examines, from the patients’ perspectives, why both rural and urban residents seek medical care in an ED. The aim of the study was to gain a better understanding of issues related to accessing health care and the rationale for persons presenting to a non-rural emergency department for health care. The ED continues to be a safety net for patients who have difficulty accessing the health care system. The identified barriers provide opportunities for healthcare system improvements, healthcare provider education, public education and continued research to ultimately improve access to care outside of the ED setting. <br/><br/><br/>en_GB
dc.date.available2011-12-21T12:46:36Z-
dc.date.issued2011-12-21T12:46:36Z-
dc.date.accessioned2011-12-21T12:46:36Z-
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