Introduction: There are several options for receiving acute care besides emergency departments (ED), such as primary care physician (PCP) offices, urgent care centers (UCC), and telehealth services. It is unknown whether these alternative modes of care have decreased the number of ED visits for patients or whether they are considered before visiting the ED. A comprehensive study considering all potential methods of care is needed to address the evolving landscape of healthcare. Our goal was to identify any factors or barriers that may have influenced a patient’s choice to visit the ED as opposed to a UCC, PCP, another local ED, or use telehealth services.
\nMethods: We surveyed ED patients between three hospital sites in the greater Buffalo, NY, area. The survey consisted of questions regarding the patients’ reasons and rationale for choosing the ED over the alternative care options. The study also involved a health record review of the patients’ diagnoses, tests/procedures, consults, and final disposition after completion of the survey.
\nResults: Of the 590 patients consented and surveyed, 152 (25.7%) considered seeking care at a UCC, 18 (3.1%) considered telehealth services, and 146 (24.7%) attempted to contact their PCP. On the recommendation of their PCP, patients presented to the ED 110 (20.7%) times and on the recommendation of the clinician at the UCC 54 (9.2%) times. Patients’ perceived seriousness of their condition was the most common reason for their selected mode of transport to the ED and reason for choosing the ED as opposed to alternative care sites (PCP, UCC, telehealth). Based on criteria for an avoidable ED visit, 83 (14.1%) ED patients met these criteria.
\nConclusion: Individuals prioritize the perceived severity of their condition when deciding where to seek emergency care. While some considered alternatives (PCP, UCC, telehealth services), uncertainties about their condition and recommendations from other clinicians led many to opt for ED care. Our findings suggest a potential gap in understanding the severity of symptoms and determining the most suitable place to seek medical care for these particular conditions.
","language":null,"license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"emergency department"},{"word":"Urgent Care Center"},{"word":"Primary Care Physician"},{"word":"Telehealth"},{"word":"Hospital Utilization"}],"section":"Emergency Department Operations","is_remote":true,"remote_url":"https://escholarship.org/uc/item/2dx1c08p","frozenauthors":[{"first_name":"Charles","middle_name":"W.","last_name":"Stube","name_suffix":"","institution":"University at Buffalo, Department of Emergency Medicine, Buffalo, New York","department":""},{"first_name":"Alexander","middle_name":"S.","last_name":"Ljungberg","name_suffix":"","institution":"University at Buffalo, Department of Emergency Medicine, Buffalo, New York","department":""},{"first_name":"Jason","middle_name":"A.","last_name":"Borton","name_suffix":"","institution":"University at Buffalo, Department of Emergency Medicine, Buffalo, New York","department":""},{"first_name":"Kunal","middle_name":"","last_name":"Chadha","name_suffix":"","institution":"University at Buffalo, Department of Pediatrics, Buffalo, New York","department":""},{"first_name":"Kyle","middle_name":"J.","last_name":"Kelleran","name_suffix":"","institution":"University at Buffalo, Department of Emergency Medicine, Buffalo, New York","department":""},{"first_name":"E.","middle_name":"Brooke","last_name":"Lerner","name_suffix":"","institution":"University at Buffalo, Department of Emergency Medicine, Buffalo, New York; University at Buffalo, Department of Pediatrics, Buffalo, New York","department":"None"}],"date_submitted":"2023-12-22T00:01:46Z","date_accepted":"2024-07-22T22:47:25.472000Z","date_published":"2024-09-25T13:00:00Z","render_galley":{"label":"Final Article","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/18647/galley/26476/download/"},"galleys":[{"label":"Layout","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/18647/galley/25980/download/"},{"label":"Final Article","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/18647/galley/26476/download/"}]}