How Low-Income Residents Decide Between Emergency and Primary Health Care for Non-Urgent Treatment

Overcrowding in U. S. emergency departments (ED) is a growing national problem that results in delayed or obstructed care and costs taxpayers billions of dollars each year. Studies show that access to a primary health care home reduces ED use, but more research is needed to determine how to best redirect vulnerable populations to primary care. Using data from forum group discussions with residents in a low-income, urban community, this study examined the decision processes residents used to decide whether to seek primary versus emergency care. Although residents exhibited high levels of knowledge about the primary health care resources available to them, they voiced a number of negative attitudes toward the services and identified barriers that discouraged them from taking advantage of these resources. The implications of these findings for campaigns aimed at discouraging non-emergency use of emergency services and promoting primary health care use, and studies of vulnerable populations' access to primary health care more generally are discussed.