Nonurgent use of hospital emergency departments: urgency from the patient's perspective.

BACKGROUND: Patients often seek care from hospital emergency departments (EDs) for conditions medical personnel perceive as nonurgent. The purpose of this study was to examine ED patients' perceptions of urgency, and to determine whether patients with no regular source of medical care are more likely to use the ED for problems they perceive as nonurgent.
METHODS: We surveyed 268 patients in an urban ED waiting area who were considered nonurgent by the ED triage nurse. Using structured interviews, we determined patients' perceptions, about the urgency of their medical condition, whether they had a regular source of medical care, and their reasons for choosing the ED for care. After controlling for other variables, we determined whether having non regular source of care was associated with patient-rated nonurgent ED utilization.
RESULTS: Eighty-two percent of patients rated their condition as urgent. Patient-rated urgency was not associated with having a regular source of care. The most common reason for seeking care in the ED was expediency.
CONCLUSIONS: A large majority of ED patients perceive the problems for which they seek care from an ED as urgent, even when they are assessed as nonurgent by a health professional. Lack of a regular source of care has no significant impact on ED utilization for problems that patients perceive as nonurgent. Simply providing patients with a regular source of care is unlikely to have a significant impact on nonurgent ED utilization without efforts to manage utilization and ensure adequate access to primary care.