Emergency Department Versus Primary Care Use: A Patient Perspective

When faced with an acute illness, patients routinely make the decision of whether to present to their primary care physician (PCP) or the emergency department (ED). While the ED is known to be a high-cost component of the health care system, many ED visits include nonurgent ailments that could easily be treated within the medical home/primary care office. Particularly for patients who have an established PCP, the factors driving a preference for ED use remain poorly understood. The purpose of this study was to better understand patient motivation for visiting the ED rather than the PCP office.

This observational study aimed to take a qualitative look at the patient population using a health system ED in the city of Wilkes Barre, PA, from December 2021 to March 2022. We conducted 30 interviews of patients who recently visited the ED and analyzed the responses for recurring themes.

Major themes included the benefit of the PCP-patient relationship, patients' preference for multiple sources of medical guidance, patients' subjectively justifying their symptoms as emergent, seeking emergent care despite perception of higher cost, and factoring in time spent at a health care facility waiting for answers.

This study contributes to further understanding of the values that drive ED use by using patient voice as a powerful tool to understand communities and local trends, which will allow health care systems to adapt and personalize protocols to their specific population.