Home > Qualitative exploration of why people repeatedly attend emergency departments for alcohol-related reasons.

Parkman, Tom and Neale, Joanne and Day, Ed and Drummond, Colin [Biomed Central] . (2017) Qualitative exploration of why people repeatedly attend emergency departments for alcohol-related reasons. BioMed Central. BMC Health Services Research, 17 (140) DOI: 10.1186/s12913-017-2091-9

URL: https://bmchealthservres.biomedcentral.com/article...

Background: Understanding why people repeatedly attend Emergency Departments (EDs) for alcohol-related reasons is an important prerequisite to identifying ways of reducing any unnecessary demands on hospital resources. We use Andersen’s Behavioural Model of Health Services Use to explore factors that contributed to repeat ED attendances.

Methods: Qualitative interviews were conducted with 30 people who repeatedly attended EDs for alcohol-related reasons (≥10 attendances in the past 12 months). We recruited participants from 6 EDs in London, United Kingdom. Data on socio-demographic characteristics, substance use, contact with specialist addiction and other health services, most recent ED attendance, and previous ED attendances were analysed.

Results: Participants reported long-standing health problems, almost all were unemployed, and many had limited education and unstable housing. Most held positive health beliefs about EDs, despite some negative experiences. They reported limited community resources: poor social support, inaccessible primary care services, dislike or lack of information about specialist addiction services, and difficulties travelling to services. In contrast, EDs offered immediate, sympathetic care and free transport by ambulance. Participants’ perceived need for care was high, with physical injury and pain being the main reasons for ED attendance.

Conclusions: Push’ and ‘pull’ factors contributed to repeated ED use. ‘Push’ factors included individual-level problems and wider community service failings. ‘Pull’ factors included positive experiences of, and beliefs about, ED care. Community services need to better engage and support people with complex drinking problems, whilst ED staff can be more effective in referring patients to community-based services.


Item Type:Evidence resource
Drug Type:Alcohol
Intervention Type:AOD disorder, AOD disorder harm reduction, Education and training, Psychosocial treatment method
Source:Biomed Central
Date:February 2017
Publisher:BioMed Central
Volume:17
Number:140
EndNote:View
Subjects:B Substances > Alcohol
G Health and disease > Substance use disorder > Alcohol use > Alcohol intoxication
G Health and disease > Substance use disorder > Alcohol use > Alcohol dependence
G Health and disease > Disorder by cause > Injury
J Health care, prevention and rehabilitation > Treatment and maintenance > Patient attitude toward treatment
J Health care, prevention and rehabilitation > Care by type of problem > Emergency care
J Health care, prevention and rehabilitation > Health care programme or facility > Hospital
J Health care, prevention and rehabilitation > Health care programme or facility > Community-based treatment (primary care)
T Demographic characteristics > Doctor
T Demographic characteristics > Nurse / Midwife

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