USING THE HOSPITAL EMERGENCY DEPARTMENT AS A REGULAR SOURCE OF CARE

Objectives: to evaluate the proportion of the patients who report the emergency department as their regular source of care and to describe t he demographics and health status of this population. Design: A cross- sectional study was performed at the emergency department in two hospi tals (around 12.000 visits per year each), Subjects were interviewed u sing a standardised questionnaire, before and after the emergency depa rtment visit. Setting: The medical emergency department of two univers ity hospitals, one in Paris and one in Besancon (France). Subjects: Ea ch patient aged 15 and more attending the emergency department for a v isit during forty randomly selected periods of 12 hours was included. Main outcome measures: Self report of the utilization of the emergency department as a regular source of care. Results: Fourteen percent of the patients cited the emergency department as a regular source of car e in Paris, and 3.3% in Besancon. In Paris, young age, being born outs ide of France, homelessness or precarious housing, lack of social supp ort in case of illness and lack of health insurance were independently associated with his health care utilization behavior. Conclusions: Fr om a public health point of view, the patients reported to use the eme rgency department as;a primary health care structure should not be con sidered as 'inappropriate' or 'abusers'. Specific health needs have be en found, which would require some continuity of care, a task for whic h the emergency department is not organised nowadays.