Delay in seeking emergency care

Objective: To determine whether patient clinical and socioeconomic characte ristics predict patient delay in coming to the emergency department (ED). M ethods: Adult ED patients at five urban teaching hospitals were surveyed re garding self-reported delay in coming to the ED. Delay was measured by self -perception as well as by the number of days ill and unable to work. Patien t socioeconomic and clinical characteristics were obtained by survey questi onnaire and chart review. Cross-sectional analysis within a prospective stu dy of 4,094 consecutive patients was performed using a subset of 1,920 pati ents (84% eligible rate) to whom questionnaires were administered. Results: Overall, 32% of the patients completing the survey reported delay in seeki ng ED care. Of these patients reporting delay, 71% thought their problem wo uld go a away or was not serious. Patients who were older, had higher acuit y, or were frequent ED users reported less delay in coming to the ED, while patients without a regular physician or who were African American reported more delay. Perception of increased number of days ill prior to visiting t he ED was reported by frequent ED users and those with worse baseline physi cal function, while patients who had higher acuity reported fewer days ill prior to coming to the ED. Conclusions: A patient's decision to delay comin g to the ED often reflects a belief that his or her illness is either self- limited or not serious. The decision to delay correlates with patient chara cteristics and access to a regular physician. The correlates of delay in se eking ED care may depend on the delay measure used. Better understanding of patients at risk for delaying care may influence interventions to reduce d elay.