A Comparison of Emergency Department Users and Residents

Abstract

<p>This thesis is a report of the analysis of the patient, use and illness characteristics of the visitors of two Hamilton, Ontario emergency departments. Emergency room utilization has increased greatly, in recent years; much of this increase has been due to non-urgent emergency visits. Consequently, in this study characteristics of emergency use and, specifically, non-urgent use were examined.</p> <p>The socio-demographic characteristics of a 1971 random sample of residents of North Hamilton were compared to the 1971 Census to establish the representative nature of this random sample. The emergency department users of the Hamilton General Hospital who reside in North Hamilton were compared to the random sample of residents. The emergency department users were characterized as being male, non-single, Protestants, native Canadians, less educated and of lower social class. The users were separated into two groups by urgency classification (emergency-urgent 52%; non-urgent 48%) and compared with the sample of residents. Non-urgent users were characterized as being younger and as having less residential tenure both in Hamilton and at their present address than residents in general. No characteristics differentiated the emergency-urgent users from residents. A younger age profile was the only socio-demographic characteristic which differentiated the two groups of urgency status. Four of the 16 illness variables separated these two groups: the emergency-urgent users were more likely to have been involved in an accident, suffered trauma, arrived by ambulance and preferred are at the emergency department.</p> <p>The users of the emergency department at St. Joseph's Hospital who also resided in North Hamilton were compared with the users from the Hamilton General. The St. Joseph's users were more likely to be younger, single, and Catholic than the users of the General. Although the General users were more likely to have suffered trauma, they were less likely to be classified as emergency-urgent than the users at St. Joseph's Hospital.</p> <p>The roles that the two emergency departments play for the residents of North Hamilton are analyzed. Although both serve as acute care, trauma centres, the General is functioning relatively more as a physician surrogate for some North Hamilton residents. Accessibility and availability of alternate primary care services are discussed for the non-urgent patient. Recommendations are offered to alleviate the demand placed on the emergency department by those most effected by its physician surrogate role.</p>