Doctoral thesis rejects theory of unnecessary emergency care

The number of visits to hospital emergency departments increased in Sweden in the late 1990ies, with longer waiting times as a result. It has been suggested, that the change could be explained by an increased tendency to seek emergency treatment for non-urgent symptoms. However, this explanation is now disputed in a new doctoral thesis from Karolinska Institutet.

In her thesis, Dr Ann-Sofie Backman has compared data from patients who visited the emergency department at the South General Hospital (Södersjukhuset) in Stockholm, with patients who used non-scheduled primary care services. Factors such as symptoms, perceived inconvenience and background information on education and social status were identified through interviews. After the medical examination, the treating physician was also asked to assess how long the patient would have been able to wait for medical assistance.

The thesis shows that the majority of patients had chosen the right level of health care. A majority of those who visited the emergency department had also used of some form of decision support, such as health care telephone hotline service.

"Emergency patients are mostly elderly people with multiple diseases", says Dr Backman. "The increase in the number of emergency department visits could probably be explained by an aging population, at least partly. However, this need further research."

Doctoral Thesis

Emergency care seeking behaviour: in relation to patients' and providers' perceptions and attitudes
Ann-Sofie Backman
Karolinska Institutet 2010, ISBN: 978-91-7457-043-4