This study investigates why some patients with apparently less urgent conditions present to emergency departments (EDs). We report on a survey of "potential primary-care" ED patients, who were asked about their reasons for choosing the ED over GPs. The sample consisted of 397 patients (with a response rate of 99% = 397/400), recruited in the former Illawarra Health Area. The three main reasons selected were: self-assessed urgency; being able to see the doctor and having tests or X-rays done in the same place; and self-assessed seriousness or complexity. The results do not appear to be sensitive to two potential sources of bias (fixed question ordering and non-random sampling). The results suggest a number of potential policy levers for encouraging some people to present to GPs rather than EDs. However, the main conclusion is that the majority of "potential primary-care" patients appear to be presenting for appropriate reasons. Thus "inappropriate attendances" do not seem to be the cause of EDs being under stress. We also argue that the results are useful for drawing inferences more broadly than just in relation to the Illawarra.

BackgroundParticipACTION is a Canadian physical activity (PA) communications and social marketing organization that was relaunched in 2007 after a six-year hiatus. This study assesses the baseline awareness and capacity of Canadian organizations that promote physical activity, to adopt, implement and promote ParticipACTION's physical activity campaign. The three objectives were: (1) to determine organizational awareness of both the 'original' and 'new' ParticipACTION; (2) to report baseline levels of three organizational capacity domains (i.e., to adopt, implement and externally promote physical activity initiatives); and, (3) to explore potential differences in those domains based on organizational size, sector and primary mandate.MethodsOrganizations at local, provincial/territorial, and national levels were sent an invitation via email prior to the official launch of ParticipACTION to complete an on-line survey. The survey assessed their organization's capacity to adopt, implement and externally promote a new physical activity campaign within their organizational mandates. Descriptive statistics were employed to address the first two study objectives. A series of one-way analysis of variance were conducted to examine the third objective.ResultsThe response rate was 29.7% (268/902). The majority of responding organizations had over 40 employees and had operated for over 10 years. Education was the most common primary mandate, followed by sport and recreation. Organizations were evenly distributed between government and not-for-profits. Approximately 96% of respondents had heard of the 'original' ParticipACTION while 54.6% had heard of the 'new' ParticipACTION (Objective 1). Findings indicate good organizational capacity in Canada to promote physical activity (Objective 2) based on reported means of approximately 4.0 (on 5-point scales) for capacity to adopt, implement, and externally promote new physical activity campaigns. Capacity to adopt new physical activity campaigns differed by organizational sector and mandate, and capacity to implement differed by organizational mandate (Objective 3).ConclusionAt baseline, and without specific details of the campaign, respondents believe they have good capacity to work with ParticipACTION. ParticipACTION may do well to capitalize on the existing strong organizational capacity components of leadership, infrastructure and 'will' of national organizations to facilitate the success of its future campaigns.