Why do Queenslanders seek care in emergency departments? A population study.

Objective: The present study aims to identify the main reasons for which first time and multiple users seek medical care through Queensland EDs.

Methods: A cross-sectional survey was conducted at eight public EDs among presenting patients (n = 911). The questions measured the sociodemographic characteristics of patients, their beliefs and attitudes towards ED services, and perceptions of health status. Bivariate and binary logistic regression analyses were performed to examine the differences between first time and multiple users of EDs.

Results: First time and multiple users accounted for 55.5% and 44.5%, respectively. Multiple users themselves were believed to be sicker, have poorer health status, and additional and/or chronic health conditions. Multiple users more strongly believed that their condition required treatment at an ED and perceived their condition as being very serious. Multiple users reported weekly household incomes below $600, and half of the multiple users were not working as compared with 35% first time users. Multivariate analysis showed that multiple use was significantly associated with the existence of additional health problems, having chronic condition, lower self-efficacy and need for ED treatment.

Conclusions: Patients who sought care for multiple times at EDs more often than first time users suffered from additional and chronic conditions. Their opinion of an ED as the most suitable place to address their current health problem was stronger than first time users. Any proposed demand management strategies need to address these beliefs together with the reasoning of patients to provide effective and appropriate care outside or within ED services.