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Open Access Uncovering Factors Affecting Use of the Emergency Department for Less Urgent Health Problems in Urban and Rural Areas Mettre au jour les facteurs expliquant le recours aux services d'urgence pour des problèmes de santé peu urgents dans les régions urbaines et rurales

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Abstract:

People who access the emergency department for less urgent health problems have been described as inappropriate users of the health-care system. Yet little is known about the factors precipitating such use and how these differ based on location of the emergency department. In this descriptive-correlational study guided by Andersen's Model of Health Services Use, 1,612 people who presented to an emergency department with a less urgent health problem were interviewed. Analysis revealed rural/urban differences in the characteristics of patients, nature of the problems, actions taken, and factors precipitating the visit. Despite its popularity, the predictive capabilities of Andersen's model were limited in explaining use of self-treatment or willingness to wait for treatment. The findings show that an emergency department's roles and functions vary according to its location. Such insights provide direction for developing services that respond to the needs of people with less urgent health problems that are cognizant of geographic location.

French
On dit des personnes qui se rendent à l'urgence pour des problèmes de santé peu urgents qu'elles font un usage inopportun du système de santé. Or on sait peu de choses des facteurs qui les incitent à y recourir et sur les éléments qui distinguent cette utilisation selon les endroits. Dans le cadre de cette étude descriptive et corrélationnelle fondée sur le modèle d'utilisation des services de santé Andersen, on a interrogé 1612 personnes qui se sont présentées à un service d'urgence avec un problème de santé peu urgent. L'analyse révèle qu'il existe des différences entre les régions rurales et urbaines en ce qui a trait aux caractéristiques des patients, la nature de leurs problèmes, les mesures adoptées et les facteurs qui les ont poussés à se présenter à l'urgence. Le pouvoir de prédiction du modèle Andersen s'est avéré limité, malgré la popularité de ce dernier, quand il s'est agi d'expliquer le recours aux soins auto-administrés ou la propension à attendre avant de recevoir des soins. On constate que le rôle des services d'urgence varie en fonction de leur emplacement. Ces conclusions offrent des éléments de réflexion propices à la mise en place de services s'adressant aux personnes ayant des problèmes de santé peu urgents, qui tiendraient compte de l'emplacement géographique.

Keywords: EMERGENCY DEPARTMENT; GEOGRAPHIC LOCATION; HEALTH-CARE BEHAVIOURS; HEALTH-RESOURCE UTILIZATION; LESS URGENT HEALTH PROBLEMS; RURAL; URBAN

Document Type: Research Article

Publication date: September 1, 2007

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  • CJNR is a peer-reviewed, quarterly journal published by the McGill University School of Nursing since 1969. With world-wide circulation, CJNR's primary mandate is to publish original nursing research that develops basic knowledge for the discipline and examines the application of the knowledge in practice. Research related to education and history is also welcomed, as are methodological, theoretical, and review papers that advance nursing science. Letters or commentaries about published articles are encouraged. Learn more.
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