Reasons why self-referring patients attend the emergency department during daytime differ among socioeconomic groups: A survey from Flanders.
BACKGROUND
Numerous studies have shown that during out-of-hours vulnerable patients (regarding low-education and unemployment) are more likely to seek medical help in the emergency department (ED). However, little is known about why patients seek help in the ED during daytime hours and if these reasons differ among self-referring socioeconomic groups.


OBJECTIVES
To identify the reasons why patients opt for the ED during daytime hours when primary care services are available and identify possible social differences between socioeconomic groups.


METHODS
In 2014-2015, trained fieldworkers surveyed 723 patients visiting four EDs in Flanders using a structured interview. These quantitative data were analysed using descriptive and logistic regression analyses.


RESULTS
More than one-third of the self-referring patients reported that they attend the ED during daytime hours because they perceive their (health) problem as urgent and expect they need advanced diagnostic testing. Self-referred and low-educated patients have a 1.8 higher chance (compared to their higher-educated counterparts) of attending the ED because they expect advanced diagnostic testing. Self-referred and unemployed patients have a 3.6, 2.5 and 4.4 higher chance (compared to their employed counterparts) to opt for the ED because it is their usual source of care, family/friends refer them or they postpone care too long, respectively.


CONCLUSION
We found sociodemographic differences in motives why self-referring patients in Flanders opt for the ED during daytime hours. In general, self-referring patients attend the ED because they perceive their condition as urgent and think they may need advanced diagnostic testing.
['Detollenaere|Jens|J|http://orcid.org/0000-0003-0261-8819', 'Boucherie|Julie|J|', 'Willems|Sara|S|https://orcid.org/0000-0002-6349-7785']
D000293:Adolescent D000328:Adult D001530:Belgium D003430:Cross-Sectional Studies D004522:Educational Status D004636:Emergency Service, Hospital D005260:Female D006801:Humans D016015:Logistic Models D008297:Male D008875:Middle Aged D012017:Referral and Consultation D012959:Socioeconomic Factors D013997:Time Factors D014478:Unemployment D035862:Vulnerable Populations D055815:Young Adult
reasons Emergency department socioeconomic GP referral