'Inappropriate' attenders at accident and emergency departments I: definition, incidence and reasons for attendance

Family Practice
A W Murphy

Abstract

Significant numbers of patients refer themselves to A&E departments for conditions which are neither accidents nor emergencies, relatively few of which require specific hospital treatment. These patients and their conditions have been described as 'inappropriate'. The objective of this paper is to review research relating to the definition, incidence and reasons for attendance of 'inappropriate' attenders. There is no accepted practical definition of what constitutes an 'appropriate' attender to an A&E department nor of what constitutes an 'emergency'. It is therefore not surprising that there is enormous variability (from 6 to 80%) regarding the proportion of visits judged to be inappropriate. All definitions rely completely on implicit and subjective judgements to determine appropriateness. The decision making of patients in opting to attend accident and emergency departments in preference to consulting their GP is complex, involving an interplay of social, psychological and medical factors. An analysis of reported work suggests that the most important factors are the perceived appropriateness of the condition for A&E, A&E accessibility and GP availability. A major deficiency in the available research is that patients have be...Continue Reading

Citations

Sep 28, 2000·Irish Journal of Medical Science·J MorganM J Turner
Sep 27, 2012·Internal and Emergency Medicine·Ygal PlakhtArthur Shiyovich
Nov 9, 2006·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·Matthias DavidTheda Borde
Nov 10, 2009·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·Farzaneh ShiraniHossein Asl-E-Soleimani
Mar 9, 2005·International Journal of Nursing Practice·Julianne CheekJacqueline Jones
Nov 7, 2001·Emergency Medicine Journal : EMJ·M Olsson, H Hansagi
Nov 8, 2002·Emergency Medicine Journal : EMJ·A Downing, R Wilson
Mar 22, 2006·Emergency Medicine Journal : EMJ·O S Gunnarsdottir, V Rafnsson
Nov 2, 2011·BMC Emergency Medicine·Anne-Claire DurandRoland Sambuc
Aug 13, 2014·Australasian Emergency Nursing Journal : AENJ·Matthew LutzeMichael Dinh
May 15, 2010·The American Journal of Emergency Medicine·Jason S HaukoosRoger J Lewis
Dec 8, 2007·Patient Education and Counseling·Eric Peter Moll van CharantePatrick Bindels
Aug 21, 2007·Health Policy·Pol De VosPatrick Van der Stuyft
Apr 3, 2002·Annals of Tropical Paediatrics·Saima Siddiqui, Danny O Ogbeide
Nov 25, 2003·Emergency Medicine·Andrew Wesley DentLachlan Robert McGregor
Feb 7, 2012·Journal of Evaluation in Clinical Practice·Linda HuibersMichel Wensing
Aug 19, 2015·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Connie BohMarcus Eh Ong
Dec 3, 2005·Accident and Emergency Nursing·Caroline AhlLilian Jansson
Aug 7, 2014·International Journal of Emergency Medicine·M Christien van der LindenJ Carel Goslings
Nov 20, 2004·Social Science & Medicine·Pol De VosPatrick Van der Stuyft
Jun 8, 2011·Health & Place·Jakob PetersenPhilip Atkinson
Apr 14, 2016·Emergency Medicine Journal : EMJ·Derek Burke
Feb 14, 2018·The Cochrane Database of Systematic Reviews·Daniela Gonçalves-BradleySasha Shepperd
Dec 20, 2013·The British Journal of General Practice : the Journal of the Royal College of General Practitioners·Sharif A IsmailShamini Gnani
Oct 14, 2018·BMJ Quality & Safety·Brenda LynchJohn Browne
Apr 20, 2012·Australian Health Review : a Publication of the Australian Hospital Association·Amee Morgans, Stephen Burgess
Oct 18, 2016·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·Judith L GriffinPatrick Bodenmann
Nov 16, 2012·The Cochrane Database of Systematic Reviews·Jaspreet K KhanguraSasha Shepperd
Nov 21, 2008·CJEM·Sandra SteeleW Ken Milne

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.