The characteristics of self-referrals to ER for non-urgent conditions and comparison of urgency evaluation between patients and nurses.

The aim of the study was to identify the characteristics of self-referrals for non-urgent conditions to the ER, and compare urgency evaluation between patients and nurses. The participants were 73 Israeli clients who arrived at ER without referral from a physician, during the morning shift, and were discharged home after treatment. Their average age was 39.4 years. Most of the visits resulted from orthopedic problems. Over 60% indicated that they had chosen the ER because the treatment there was better, and a third reported that they usually turn to ER when they feel sick. In most cases, the visits were within 3 h of the symptoms emerging, and about a third of the participants indicated that lately they had been under situations of stress and anxiety. Significant differences (p=0.000) were found between nurses and patients, in the urgency evaluation of the visit. While most of the clients (77%), evaluated their condition as urgent to most urgent, most of the nurses (78%) evaluated it as non-urgent. Identifying the characteristics of the non-urgent use of the ER and the differences between caregivers and patients regarding the urgency evaluation of the visit, will provide insights into the population perceived as a burden on the work of the ER as well as benefiting and improving services.

[1]  S. Carmel,et al.  Gender differences in the utilization of emergency department services. , 1991, Women & health.

[2]  J. Simpson,et al.  The district hospital emergency department: Why do parents present? , 2003, Emergency medicine.

[3]  D. Padgett,et al.  Psychosocial factors influencing non-urgent use of the emergency room: a review of the literature and recommendations for research and improved service delivery. , 1992, Social science & medicine.

[4]  J. Stessman,et al.  Factors predicting emergency room utilization in a 70-year-old population. , 1996, Israel journal of medical sciences.

[5]  S. Kimmel,et al.  Factors associated with emergency department utilization for nonurgent pediatric problems. , 2000, Archives of family medicine.

[6]  I. al-Smadi,et al.  Who uses the emergency room services? , 2000, Eastern Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al-mutawassit.

[7]  J. Koziol-Mclain,et al.  Seeking care for nonurgent medical conditions in the emergency department: through the eyes of the patient. , 2000, Journal of emergency nursing: JEN : official publication of the Emergency Department Nurses Association.

[8]  S. Abbuhl,et al.  Appropriate standards for "appropriateness" research. , 2001, Annals of emergency medicine.

[9]  R. Andersen,et al.  Societal and individual determinants of medical care utilization in the United States. , 1973, The Milbank Memorial Fund quarterly. Health and society.

[10]  Joshua H. Sarver,et al.  Usual source of care and nonurgent emergency department use. , 2002, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[11]  E. Harzheim,et al.  The relevance of continuity of care: a solution for the chaos in the emergency services. , 2002, Family practice.

[12]  B. Honigman,et al.  The chronic emergency department patient. , 1981, Annals of emergency medicine.