Where do family practice patients go in case of emergency?

OBJECTIVE To determine the annual incidence of patient-defined emergencies and patients' use of emergency services at a family medicine teaching unit. DESIGN Cross-sectional survey. SETTING Hospital-based family medicine teaching unit in Montreal. PARTICIPANTS Registered patients attending a family medicine teaching unit during 11 consecutive weekdays. MAIN OUTCOME MEASURES Annual incidence of patient-defined medical emergenci es and use of emergency services at the unit. RESULTS Eligible patients made 815 visits during the study period; 584 usab le questionnaires were returned for a response rate of 71.7%. In the previo us 12 months, 37% of patients reported at least one medical emergency. For their last emergency, 42% reported using at least one of the emergency serv ices offered by the clinic. Only 19% of patients with after-hours emergenci es reported using our on-call system. Although socioeconomic and clinical v ariables did not predict the incidence of patient-defined emergencies, mult ivariate analysis revealed three significant predictors for use: patients w ith the practice for 5 or more years were more likely to use our services, while patients 75 and older and those with emergencies after hours were les s likely to use our services. CONCLUSIONS In an urban group family practice, annual incidence of medical emergencies among registered patients was 37%. Those whose most recent emer gency occurred after hours used the clinics' emergency on-call services dis appointingly little.