| Perceived Reason | Verbatim Comments |
|---|---|
| Lack of understanding of health care/urgent concerns | “Some might be lack of education, I don't know how much that is. Because when I talk to patients, half or most of them know they could have gone, but they say they couldn't get them in that quick… . So, I think it's to them, the complaint might be emergent to them. But in reality, it's not an emergency.” (ED nurse) “So if you come in with like, a UTI, or a little rash, you're obviously … you don't have the potential to be admitted. You probably don't even need to be seen by a doctor.” (PC physician) “Either poor education, not understanding that it's not an emergent situation, or they don't agree with my plans.” (PC physician) |
| Convenience | “… another is the belief that if I need these sort of tests, X-rays, or whatever, most doctors' offices don't have X-rays there. At least, many of them don't. We don't have them here. So, if people think they're going to need an X-ray, or some sort of fancy thing then they may be more inclined to run to the emergency room. Even if it's not something as obvious as severe chest pain.” (PC physician) “Lack of primary care follow-up, lack of rapid follow-up, lack of … you know, they want to use it at different times than normal business hours. It's much easier to walk into the ED than actually find a phone number and call and make an appointment and keep an appointment, and there's no cost associated with it.” (ED physician) “They don't have to wait for the results.” (ED nurse) |
| Health care system factors | “I think one of the major drivers in that is there's no co-pay. There's no financial responsibility. There's no obligation.” (ED administrator) “You're guaranteed to be seen.” (ED physician) “If you use the ED, and you don't have a co-pay, OK, I think it's easy.” (ED nurse) “People would be coming in for things that could have easily been handled in clinic visits, but they either didn't have a PCP, or they couldn't get in soon enough, or, for whatever reason, they just decided three o'clock in the morning was the best time to go in for something that had been ongoing for days or weeks or things like that.” (PC physician) |
ED, emergency department; PC, primary care; PCP, primary care physician; UTI, urinary tract infection.