Analysis of the inappropriate utilization of the emergency service of a third-level hospital

OBJECTIVE: a) To find the reasons for inadequate use of Hospital Casualty Departments (HCDs); b) to discover the general population's levels of information concerning non-hospital Emergency Services (NESs); c) to analyse the relationship between the type of Primary Care Centre (PCC), i.e. whether reformed or not, and inadequate use of HCDs. DESIGN: A crossover study. SETTING: The Germans Trias i Pujol Hospital Casualty Department, Badalona. PATIENTS: A random sample of 321 patients over 14 years old, who were attended for pathologies considered emergencies not requiring hospital treatment. MEASUREMENTS AND MAIN RESULTS: The variables gathered were: age, gender, where the patient came from, reason for hospital use, knowledge of NESs and subsequent referral. 83.2% of patients attended on their own initiative. The main reasons given were "advantages of a hospital" and "the persistence of symptoms." 49% of the patients stated they knew of the NESs. 80% of the patients proceeded from PCCs which had not been reformed. There were no statistically significant differences (p > 0.05) when the variables "reason for use" and "knowledge of NESs" were compared in relation to where the patient came from (i.e. reformed or non-reformed PCC). CONCLUSIONS: General practitioners in reformed PCCs are less likely to refer to HCDs. Knowledge and use of NESs should be actively supported.