Public use and perceptions of emergency departments: A population survey

Abstract

Main reason for attending ED is perceived severity of illness, followed by lack of alternative care. The majority of both consumers and the public are in favour of more flexible care models. However, further research is necessary to detail those alternatives and to test and validate their effectiveness.

Engaging the public in healthcare decision-making: results from a Citizens’ Jury on emergency care services

“…The jury's strong support for enhancing the roles of non-medical staff to treat patients with non-life-threatening conditions/injuries—without a medical consultation—is largely consistent with previous studies that suggest that the public support expanded roles for non-medical personnel, if safe to do so 22. As the vast majority of all public hospital ED presentations considered non-emergency cases,23 increasing the scope of all non-medical health professionals may prove worthwhile; however, the impact on staff workload would need to be managed.…”

“…The jury's strong support for enabling adequately trained ambulance staff to treat a subgroup of patients in their homes, at the scene or transfer them to alternative care services—without transporting them to the ED—are largely consistent with previous studies that suggest that the public are supportive of such initiatives 22. With a significant number of all public hospital ED presentations arriving by an ambulance service, the majority of which are not emergencies or resuscitations,23 using paramedics in these enhanced roles has the potential to moderate the growth in demand for ED services 24.…”

“…The jury believe public education is essential in order for members of the public to shift their existing views of EDs and embrace fundamental changes to the system. Such education should be directed to patients and also the wider community as the decision to attend an ED can equally fall on either party 22. The impact of education on ED demand is unknown; however, it is encouraging to note that educating the jurors, who themselves are ordinary citizens, resulted in them having a better understanding of the issues that often plague EDs and the health system and an appreciation for the need for innovative and flexible solutions.…”

“…Selecting jurors from a sample that were willing and available to sit on the jury and that resided in the same geographical area may have produced an unintended selection bias not evident in the sample demographic characteristics such that the jury's views may not have been fully representative of the broader Queensland population. The verdicts reached by this group of citizens may differ from patients who are acutely ill or injured seeking emergency care; however, there is emerging research that patients are accepting of alternative models of care 22. It remains unknown whether this approach would generate similar verdicts in members of the public outside of a group context and in policy-makers.…”

The factors that influence private health insurance holders' choice between public and private emergency departments at the time of emergency

“…Previous literature indicated that patients' health-seeking behaviour was influenced by other people (G. FitzGerald et al, 2015;Marcus & Forsyth, 2009). This was confirmed by thecurrent study, in which private ED patients were more likely to contact their GP and follow their suggestion, whereas public ED patients were more likely to contact ambulance paramedics and follow their suggestion.It is worthnoting that the 'suggested by ambulance staff' variable remains statistically significant in the final logistic regression model in predicting patients' choice between public and private hospital EDs.…”