Emergency care in Melbourne: a study of help-seeking behaviour

Between March, 1978, and September, 1979, a population-based stroke incidence study was carried out in Melbourne. Of the 508 cases of stroke that occurred in the area, 426 were in patients living at home or independently; of these, 300 sought help from a general practitioner and the remainder either called an ambulance directly or went straight to hospital by private transport. In well over 70% of instances the call to the general practitioner was responded to by a home visit; in all but four cases arrangements for care were made. There were thus four cases in which a doctor allegedly refused to attend or make other arrangement for care. Whilst severity influenced the decision to seek a general practitioner, the more severely affected patients tending to be taken directly to hospital, other major influences were age and country of birth. Younger people tended to go straight to hospital, and this suggests that, with the passage of time, the role of the casualty department may increase in importance. Patients born in non-English-speaking countries were more likely to go directly to hospital, and it is suggested that this is likely to reflect the shortage of doctors in the community who understand other cultures and speak other languages.