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A Regional Survey to Determine Factors Influencing Patient Choices in Selecting a Particular Emergency Department for Care
Author(s) -
Grafstein Eric,
Wilson Danielle,
Stenstrom Rob,
Jones Catherine,
Tolson Margreth,
Poureslami Iraj,
Scheuermeyer Frank Xavier
Publication year - 2013
Publication title -
academic emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 124
eISSN - 1553-2712
pISSN - 1069-6563
DOI - 10.1111/acem.12063
Subject(s) - medicine , emergency department , triage , confidence interval , odds ratio , ambulatory , logistic regression , cross sectional study , odds , family medicine , emergency medicine , nursing , pathology
Objectives Increases in regional emergency department ( ED ) efficiencies might be obtained by shifting patients to less crowded ED s. The authors sought to determine factors associated with a patient's decision to choose a specific regional ED . Based on prior focus group discussions with volunteers, the hypothesis was that distance to a specific ED and perceived ED wait times would be important. Methods A cross‐sectional survey was developed using qualitative focus group methodology. The resulting survey was composed of 17 questions relating to patient decisions in choosing a specific ED and was administered in each of six ED s in a single urban Canadian health region at all hours of the day. Ambulatory patients with a Canadian Triage and Acuity Scale ( CTAS ) level 3 to 5 and aged ≥19 years were surveyed. The primary outcome was the proportion of patients whose main motivation for attending a specific ED was either distance traveled to reach the ED or perceived ED waiting time. Multivariable logistic regression was performed to assess factors influencing both of these reasons. Results A total of 757 patients were approached and 634 surveys (83.8%) were completed. Distance from the ED (named by 44.0% of respondents as their primary reason) and perceived ED wait times (9.3%) were the main motivations for patients to attend a specific ED . Multivariable analysis of factors associated with choosing distance revealed that ED distance < 10 km (adjusted odds ratio [ OR ] = 2.20, 95% confidence interval [ CI ] = 1.45 to 3.33; p = 0.001) and age ≥ 60 years (adjusted OR = 1.58, 95% CI = 1.12 to 2.26; p = 0.04) were significant in choosing a particular ED . Multivariable analysis of factors influencing wait times demonstrated that having a painful complaint (adjusted OR = 1.42, 95% CI = 1.05 to 1.98; p = 0.047) and age < 60 years ( OR = 1.47, 95% CI = 1.02 to 2.14; p = 0.049) were significant in choosing a particular ED . Conclusions In a multicenter survey of patients from an urban health region, distance to a specific ED and perceived ED wait times were the most important reasons for choosing that ED . Younger patients and those with painful conditions appear to place greater priority on wait times.