Reasons why patients bypass their GP to visit a hospital emergency department

Rieffe, Carolien; Oosterveld, Paul; Wijkel, D.; Wiefferink, Carin H.

doi:10.1016/s0965-2302(99)80054-x

Cited by 30 publications

(32 citation statements)

References 10 publications

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“…Several studies exploring the characteristics and motives of self-referred patients (SRPs) for their visits to the ED have been carried out [[3]–[8]]. However, most of them were conducted before or during the introduction of the GP-cooperatives [[3],[6]–[8]].…”

Section: Introductionmentioning

confidence: 99%

Self-referred patients at the Emergency Department: patient characteristics, motivations, and willingness to make a copayment

et al. 2014

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BackgroundIn many countries, including the Netherlands, a substantial number of patients visit the Emergency Department (ED) without a referral by a general practitioner. The goal of this study was to determine the characteristics and motivations of self-referred patients (SRPs) at the ED. The secondary objective was to explore SRPs’ opinion about copayments.MethodsA survey, in seven different languages was performed among SRPs from October 2011 until January 2012 at an academic ED in the Netherlands. Patients were included on 21 day-, 21 evening-, and 21 nightshifts during week and weekend days equally. Patient characteristics, motivations, complaints, diagnosis, and the opinion regarding copayments were examined.ResultsA total of 436 SRPs were included (response rate 82%). Forty-seven percent of the ED population was self-referred. SRPs were mainly male (58%), between 18 and 35 years (54%), Dutch (67%), single without children (42%), and low-educated (73%). The most commonly presented complaints were of musculoskeletal origin (35%). Expected need for additional medical care (e.g., X-rays, blood tests) was the reason to visit the ED for 28% of the SRPs. Around 30% of the SRPs were not prepared to pay for an ED visit. Fifty percent of SRPs were prepared to pay up to 25 or 50 EUR. Highly educated patients were willing to pay more than patients with a low level of education (p < 0.05).ConclusionsSRPs (47% of the total ED population) are often young men with musculoskeletal complaints. They are convinced that additional medical tests are necessary. About 70% of the SRPs are willing to make a copayment, half of the SRPs with a maximum between 25 EUR and 50 EUR. As highly educated SRPs are prepared to pay more, introducing copayments might influence equity in health care accessibility.

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Section: Introductionmentioning

confidence: 99%

Self-referred patients at the Emergency Department: patient characteristics, motivations, and willingness to make a copayment

et al. 2014

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“…Increasing numbers of patients across Europe are bypassing the GP and primary healthcare system to present to EDs [11].…”

Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 99%

Health systems organization for emergency care

Pedroto

Amaro

Romãozinho

2013

Best Practice & Research Clinical Gastroenterology

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“…Studien aus Deutschland, den Niederlanden und der Schweiz zu diesem Themenfeld, also ärztliche Notfalldienste und deren Inanspruchnahme, belegen allerdings eine hohe Rate von Selbsteinweisungen in Klinikambulanzen unter "Umgehung" des ärzt-lichen Notfalldienstes [4,11,18,28,34,38,41].…”

Section: Die Ergebnisse Beruhen Auf Zweiseitigen Spaltenanteilstests unclassified

“Medical Emergency Services as Seen by Consumers”. Health Services Research by CATI Survey of the Community

Rau¹,

Mensing

Brand

2006

Med Klin

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A) The tiered medical emergency system should be used adequately; this aim could be attained by (1) information of the public about the "24-h" on-call service of panel doctors; information about the fact that the majority of medical conditions can be treated by panel doctors and that in severe cases a professional and quick referral will be done; information about the fact that self-referral to hospitals may reduce or even obstruct professional resources for the treatment of "real" emergency patients. Target groups are men, younger age groups and people with a higher level of education. (2) information of target groups (elderly people) about the emergency call number 112. (3) information of the public about the national phone number 19222 for patient transports. B) Structural measures such as (1) specific on-call services, (2) improvement of the transparency and reach-ability of panel doctors' on-call services.

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Reasons why patients bypass their GP to visit a hospital emergency department

Cited by 30 publications

References 10 publications

Self-referred patients at the Emergency Department: patient characteristics, motivations, and willingness to make a copayment

Self-referred patients at the Emergency Department: patient characteristics, motivations, and willingness to make a copayment

Health systems organization for emergency care

“Medical Emergency Services as Seen by Consumers”. Health Services Research by CATI Survey of the Community

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