The non-emergency in the emergency room.

During designated sampling periods, all patients presenting at an urban hospital Emergency Room with complaints meeting nonurgent criteria were interviewed in an effort to examine patterns of Emergency Room usage and to characterize those patients utilizing the Emergency Room inappropriately. Each such patient's stated number of visits to an Emergency Room during the previous year, including the present visit, was used as an indicator in assessing inappropriate Emergency Room use. Statistical analysis showed no significant differences when the variable was race; in contrast, significant differences were seen when the variables were type of medical insurance coverage and personal physician status. Based on these data, we suggest that the true problem is not one of how to control inappropriate Emergency Room use, but rather one of how to improve the health care delivery system for the urban poor.