Indicated trauma emergency department utilization - A comparison between patient's self-assessment and professional evaluation

Introduction: Patient visits to emergency departments (EDs) increase in many countries. As a result, these facilities are often congested and the socioeconomic burden of growing workload is a well-known problem. In this study, patient's reasons attending an ED with non-emergent needs were analyzed. Methods: From October 2015 to March 2016 patients (n = 499), attending the ED of an academic teaching hospital without referral from a General Practitioner (GP) were surveyed regarding circumstances of their visit, a self-assessment of illness-severity, and reasons for choosing the ED instead of a GP. Results were compared to responses of ED staff (n = 40). Results: Most patients assessed their case as urgent (patients: 65% vs. ED staff: 28%, p < 0.001) and felt that their medical problem could not to be treated by a GP (74%). However, most patients ranked their injuries as mild (45.7%) or moderate (41.7%). Reasons to prefer an ED instead of a GP were not responded in 80.1% of cases. Conclusion: In contrast to the self-evaluation of patients, ED staff believed that a significant portion of medical problems could be treated by a GP. Understanding patient-centred reasons and the discrepancy between self-perceived emergencies and minor medical problems might help to reduce inappropriate ED-admissions.