Programme no. 225-OP
Public Health
Is it a matter of urgency? - A descriptive survey of patients’ and general practitioners’ assessments of how acutely they estimate the need for help at an emergency primary health care clinic in Oslo
Sven Eirik Ruud*1, Per Hjortdahl2, Bård Natvig3
1Department of General Practice,University of Oslo/Institute of Health and Society,Oslo,Norway, 2Department of General Practice,University of Oslo/Institute of Health and Society,Oslo,Norway, 3Department of General Practice,University of Oslo/Institute of Health and Society,Oslo,Norway
* = Presenting author
Objectives: The primary aim of this study is to explore whether there are any differences in assessment of how acutely the patients’ and physicians’ estimate the need for help in a population of walk-in patients visiting an emergency primary health care clinic. The second aim is to evaluate whether there are any differences in assessment between native Norwegians, immigrants and subgroups of immigrant based on country of origin. Finally, we want to explore whether there is a correlation between the physicians’ and the patients’ experience of urgency of the health care enquiry, and whether there are any associations between patients’ assessment of urgency and consultation-outcomes.
Background:

Emergency room (ER) usage is increasing in several countries. At the same time several studies report that 20-40% of ER patients present with non-urgent problems that could have been handled appropriately by regular general practitioners (RGPs). Non-urgent emergency claims are considered to be an inappropriate and inefficient use of the health care system because it may lead to higher expenses, crowding and treatment delays. It has been reported that immigrants tend to use emergency rooms and out-of-hours services for non-urgent purposes.

Results: Preliminary analyses have indicated a huge discrepancy between patients' and GPs' assessments of how acutely they define the need for help. Patients estimate the urgency to a higher extent than GP’s and immigrants estimate the health enquiry more urgent than native Norwegians. Further detailed analysis according to study aims will be explored in future analysis.
Material/Methods: A multilingual anonymous questionnaire/registration survey was administered to all walk-in patients at an emergency primary health care clinic in Oslo during two weeks in September 2009. 1.850 patients were included in the analysis where the proportion of immigrants and Norwegian-born to immigrant parents constituted 42%. Both patients’ and general practitioners’ assessment related to how acutely they estimated the need for help was noted. Immigration status, country of origin and demographic data were collected.
Conclusion: Inappropriate use of emergency health care services is inexpedient and involves a burden to the emergency health care system. Patients lose the continuity of health care provided by a RGP. Our study will contribute to further knowledge about emergency health care utilization and health seeking behaviour.
Points for discussion:

Patients present emergency services with non-urgent problems that could have been handled appropriately by RGPs. Cultural differences according to health understanding and poor knowledge about the health care system and not being assigned to a RGP may contribute to increased use of emergency services by immigrants.