How do prudent laypeople define an emergency medical condition?

To determine the public's perception as to the general definition of an eme rgency medical condition (EMC), and to compare opinions between the general public and healthcare workers (HCW) on which specific medical conditions r equire emergency department (ED) care, a survey of people at 12 supermarket s and shopping malls in Northern California was conducted over a 6-month pe riod in 1997, Individuals over age 18 were asked in person to complete a su rvey sheet. It asked participants to choose one of four definitions of "eme rgency medical condition." In addition, people were asked to determine whic h of 30 chief complaints the) thought needed care in the ED, Demographic in formation was also collected. A second set of surveys asking the same quest ions was conducted among nonemergency healthcare providers at hospitals. He althcare worker was defined as an MD, RN, LVN, or PA. A total of 1,018 memb ers of the public and 126 healthcare workers completed the survey, EMC defi nitions selected by the public were: 1) an abbreviated federal EMTALA defin ition: a condition that may result in death, permanent disability, or sever e pain (48.7%); 2) the federal definition plus other conditions preventing work (3.0%); 3) the federal definition plus any other conditions outside bu siness hours (16.5%); and 4) any condition at any time as determined by the patient (31.6%). HCWs selected the following: definition 1 (71%); definiti ons 2 and 3 (0%); and definition 4 (27%). Definitions 1 and 3 were statisti cally different when comparisons were made between the public and HCWs. On the question of which of the 30 chief complaints needed care in an ED, agre ement was seen between the public and HCWs for severe abdominal pain (94% v s, 99%, respectively) and severe chest pain (96% vs, 99%, respectively), Ho wever, the two disagreed on the need for ED care for severe headache (58% v s, 91%, respectively); mild chest pain (51% vs, 79%, respectively); and dif ficulty breathing (77% vs. 98%, respectively), No significant difference in opinions on the need for ED care was seen for some minor conditions: mild headache, sore throat, cough, flu symptoms, minor foot problems. No signifi cant differences in answers occurred when age groups, occupations, or locat ions were compared. In conclusion, the public has split views concerning th e general definition of an emergency medical condition, Approximately half uses a conservative federal definition, and half uses patient self-determin ed need as the definition, Data on which specific conditions need ED care p rovide additional insight on agreement between the public and HCWs on most problems, Both groups agree that many perceived minor medical complaints do not require ED care. (C) 1999 Elsevier Science Inc.