Accessing care: use of a specialized women's emergency care facility for nonemergent problems

Given the problem of emergency room overcrowding, this study was designed to examine factors associated with women seeking treatment for medically nonemergent conditions in a primarily obstetric and gynecologic emergency facility.

This is a prospective study of 287 women coming for non-emergent reasons to the Women & Infants Hospital Emergency Room/Triage Unit (WIH ER/Triage Unit). Participants completed questionnaires to assess reasons for choosing to seek care in the emergency room, symptoms, and past medical care. Data abstracted and analyzed from the participants' medical records included demographic information, recorded urgency level, pregnancy status, and medical reasons for the visit.

Of the 287 women completing the questionnaire, 36% came because they believed they had a true emergency, 42% because of physician referral, and 21% because of access barriers. Eighty-four percent of participants reported having a primary physician, and 56% registered for care on weekdays between 9 AM and 5 PM. Seventy percent reported a reason for the visit that was related to either obstetrics or gynecology. Common symptoms among women coming to this emergency department (ED) included abdominal or pelvic pain (32%) and vaginal bleeding (22%). Seventeen percent came for diagnostic testing, such as ultrasound or laboratory testing.

Although women with nonemergent medical conditions who came to a specialized emergency facility for care had a usual source of medical care, that source of care was not always accessible or available to them.