Non-urgent emergency department visits: the effect of having a regular family doctor

Abstract

Over the past years, there has been an increased incidence of non-urgent visits to the Accident and Emergency Department of Mater Dei Hospitat Malta. This results in severe overcrowding of this department and, hence, substantial decrease in efficiency and inadequate utilisation of resources. Most of these patients were noted to be using the Accident and Emergency department as their primary source of care. The aim of this study is to determine how many of these patients have a regular family doctor or primary care provider, whom they seek advice from prior to attending the Accident and Emergency Department. This would prove to be beneficial in understanding the dynamics associated with inappropriate utilisation of the Accident and Emergency Department and lack of primary care use, providing the basis of a framework which would help to attempt to solve the ever-increasing load on the Accident and Emergency Department and also to improve primary care by making it more accessible and improving it to make it meet patient's demands. This study was based on the Andersen-Newman model of health services utilisation by developing a questionnaire, which was then, administered to patients who had attended the department for non-urgent purposes over a previously determined period of time.

This self-reported telephone survey was carried out on one hundred and ninety-eight patients out of a quasi-random sample of two hundred and twenty five patients. Out of the various socio-demographic factors studied, none of these were statistically found to be significant in determining the utilisation of the said-department for non-urgent purposes.

Results obtained showed no correlation between non urgent visits to the accident and emergency department and having a regular family doctor. Various other correlating variables including age, level of education and average weekly household income among others were also tested, however none proved to be statistically significant. In future, the same study can be carried out on a larger population sample, thus increasing the chance of statistical significance.