Why do they do that?: Looking beyond typical reasons for non-urgent ED use among Medicaid patients

Barriers to accessing primary care, including lack of transportation and inadequate appointment times, are common reasons for non-urgent emergency department (ED) use yet even when these barriers are addressed, the problem persists. This study explored non-urgent ED use by Medicaid enrollees through...

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Autores principales:	Cynthia Sieck, Jennifer Hefner, Randy Wexler, Chris Taylor, Ann McAlearney
Formato:	article
Lenguaje:	EN
Publicado:	The Beryl Institute 2016
Materias:	healthcare qualitative methods patient experience emergency department primary care access Medicine (General) R5-920 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/aada52f06b984e849545ff25957a4c1f
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spelling	oai:doaj.org-article:aada52f06b984e849545ff25957a4c1f2021-11-15T04:21:49ZWhy do they do that?: Looking beyond typical reasons for non-urgent ED use among Medicaid patients2372-0247https://doaj.org/article/aada52f06b984e849545ff25957a4c1f2016-11-01T00:00:00Zhttps://pxjournal.org/journal/vol3/iss2/5https://doaj.org/toc/2372-0247Barriers to accessing primary care, including lack of transportation and inadequate appointment times, are common reasons for non-urgent emergency department (ED) use yet even when these barriers are addressed, the problem persists. This study explored non-urgent ED use by Medicaid enrollees through interviews with patients and providers and sought to identify themes beyond the commonly mentioned logistical and access issues. Qualitative interviews with 23 Medicaid enrollees and 31 PCP and ED providers utilizing a semi-structured interview guide focused on reasons for seeking care in the ED and issues associated with PCP appointments. We identified overlap as well as surprising differences in themes identified by providers and by patients. Providers identified cultural and educational issues including that many Medicaid patients had grown up using the ED as their main source of care and lacked awareness of other sources healthcare. Patients did not mention educational and cultural factors directly, but discussed a concern that their condition was too serious for the PCP, or that the ED provided more comprehensive services. Both patients and providers raised neglected concepts, particularly those related to understanding primary care compared to emergency care. These results highlight the importance of addressing multiple paths toward more appropriate ED use, including barriers beyond logistical and access-related concerns. Considering the patient’s perception of the situation, as well as identifying opportunities to improve patients’ understanding of where to seek care may help to create interventions with broader impact than those that address access and logistical barriers alone.<strong></strong>Cynthia SieckJennifer HefnerRandy WexlerChris TaylorAnn McAlearneyThe Beryl Institutearticlehealthcarequalitative methodspatient experience emergency departmentprimary careaccessMedicine (General)R5-920Public aspects of medicineRA1-1270ENPatient Experience Journal (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	healthcare qualitative methods patient experience emergency department primary care access Medicine (General) R5-920 Public aspects of medicine RA1-1270
spellingShingle	healthcare qualitative methods patient experience emergency department primary care access Medicine (General) R5-920 Public aspects of medicine RA1-1270 Cynthia Sieck Jennifer Hefner Randy Wexler Chris Taylor Ann McAlearney Why do they do that?: Looking beyond typical reasons for non-urgent ED use among Medicaid patients
description	Barriers to accessing primary care, including lack of transportation and inadequate appointment times, are common reasons for non-urgent emergency department (ED) use yet even when these barriers are addressed, the problem persists. This study explored non-urgent ED use by Medicaid enrollees through interviews with patients and providers and sought to identify themes beyond the commonly mentioned logistical and access issues. Qualitative interviews with 23 Medicaid enrollees and 31 PCP and ED providers utilizing a semi-structured interview guide focused on reasons for seeking care in the ED and issues associated with PCP appointments. We identified overlap as well as surprising differences in themes identified by providers and by patients. Providers identified cultural and educational issues including that many Medicaid patients had grown up using the ED as their main source of care and lacked awareness of other sources healthcare. Patients did not mention educational and cultural factors directly, but discussed a concern that their condition was too serious for the PCP, or that the ED provided more comprehensive services. Both patients and providers raised neglected concepts, particularly those related to understanding primary care compared to emergency care. These results highlight the importance of addressing multiple paths toward more appropriate ED use, including barriers beyond logistical and access-related concerns. Considering the patient’s perception of the situation, as well as identifying opportunities to improve patients’ understanding of where to seek care may help to create interventions with broader impact than those that address access and logistical barriers alone.<strong></strong>
format	article
author	Cynthia Sieck Jennifer Hefner Randy Wexler Chris Taylor Ann McAlearney
author_facet	Cynthia Sieck Jennifer Hefner Randy Wexler Chris Taylor Ann McAlearney
author_sort	Cynthia Sieck
title	Why do they do that?: Looking beyond typical reasons for non-urgent ED use among Medicaid patients
title_short	Why do they do that?: Looking beyond typical reasons for non-urgent ED use among Medicaid patients
title_full	Why do they do that?: Looking beyond typical reasons for non-urgent ED use among Medicaid patients
title_fullStr	Why do they do that?: Looking beyond typical reasons for non-urgent ED use among Medicaid patients
title_full_unstemmed	Why do they do that?: Looking beyond typical reasons for non-urgent ED use among Medicaid patients
title_sort	why do they do that?: looking beyond typical reasons for non-urgent ed use among medicaid patients
publisher	The Beryl Institute
publishDate	2016
url	https://doaj.org/article/aada52f06b984e849545ff25957a4c1f
work_keys_str_mv	AT cynthiasieck whydotheydothatlookingbeyondtypicalreasonsfornonurgenteduseamongmedicaidpatients AT jenniferhefner whydotheydothatlookingbeyondtypicalreasonsfornonurgenteduseamongmedicaidpatients AT randywexler whydotheydothatlookingbeyondtypicalreasonsfornonurgenteduseamongmedicaidpatients AT christaylor whydotheydothatlookingbeyondtypicalreasonsfornonurgenteduseamongmedicaidpatients AT annmcalearney whydotheydothatlookingbeyondtypicalreasonsfornonurgenteduseamongmedicaidpatients
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Why do they do that?: Looking beyond typical reasons for non-urgent ED use among Medicaid patients

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