Observational studyBMC family practice2013
The impact of neighborhood deprivation on patients' unscheduled out-of-hours healthcare seeking behavior: a cross-sectional study.
Observational study in BMC family practice, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Older People's Help-Seeking Behaviors in Rural Contexts: A Systematic Review.International journal of environmental research and public health · 2022Pooled it
- County-Level Influenza-Attributable Emergency Department Visits and Their Spatial Correlates in the United States: Cross-Sectional Observational Study.JMIR public health and surveillance · 2025Observational
- The role of mesolevel characteristics of the health care system and socioeconomic factors on health care use - results of a scoping review.International journal for equity in health · 2024Article
- Educational differences in healthcare use among survivors after breast, prostate, lung, and colon cancer - a SEQUEL cohort study.BMC health services research · 2023Article
- The association between socioeconomic status and use of potentially inappropriate medications in older adults.Journal of the American Geriatrics Society · 2023Article
- Adverse Childhood Experiences, Depression, Patient Activation, and Medication Adherence Among Patients With Uncontrolled Hypertension.American journal of hypertension · 2023Article
- Healthcare service utilization for formerly homeless veterans in permanent supportive housing: Do neighborhoods matter?Psychological services · 2022Article
- Differences between recorded diagnoses of patients of an emergency department and office-hours primary care doctors: a register-based study in a Finnish town.International journal of circumpolar health · 2021Article
- Stuff you think you can handle as a parent and stuff you can't'. Understanding parental health-seeking behaviour when accessing unscheduled care: A qualitative study.Health expectations : an international journal of public participation in health care and health policy · 2021Article
- The Association between the Self-Management of Mild Symptoms and Quality of Life of Elderly Populations in Rural Communities: A Cross-Sectional Study.International journal of environmental research and public health · 2021Article
- What resources do elderly people choose for managing their symptoms? Clarification of rural older people's choices of help-seeking behaviors in Japan.BMC health services research · 2021Article
- Impact of Socioeconomic Status on Adult Patients with Asthma: A Population-Based Cohort Study from UK Primary Care.Journal of asthma and allergy · 2021Article
- Article
- Observational
- Who attends out-of-hours general practice appointments? Analysis of a patient cohort accessing new out-of-hours units.BMJ open · 2018Article
- The role of health literacy in explaining the association between educational attainment and the use of out-of-hours primary care services in chronically ill people: a survey study.BMC health services research · 2018Article
- The effect on the patient flow in local health care services after closing a suburban primary care emergency department: a controlled longitudinal follow-up study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2017Observational
- Migrants' motives and expectations for contacting out-of-hours primary care: a survey study.BMC family practice · 2017Article
- Racial Differences in Pediatric Emergency Department Triage Scores.The Journal of emergency medicine · 2016Article
- Primary care characteristics and their association with health screening in a low-socioeconomic status public rental-flat population in Singapore- a mixed methods study.BMC family practice · 2016Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe use of unscheduled out of hours medical care is related to the social status of the patient. However, the social variance in the patient's preference for a hospital based versus a primary care based facility, and the impact of specific patient characteristics such as the travel distance to both types of facilities is unclear. This study aims to determine the social gradient in emergency care seeking behavior (consulting the emergency department (ED) in a hospital or the community-based Primary Care Center (PCC)) taking into account patient characteristics including the geographical distance from the patient's home to both services.
methodsA cross-sectional study, including 7,723 patients seeking out-of-hours care during 16 weekends and 2 public holidays was set up in all EDs and PCCs in Ghent, Belgium. Information on the consulted type of service, and neighborhood deprivation level was collected, but also the exact geographical distance from the patient's home to both types of services, and if the patient has a regular GP.
resultsPatients living in a socially deprived area have a higher propensity to choose a hospital-based ED than their counterparts living in more affluent neighborhoods. This social difference persists when taking into account distance to both services, having a regular GP, and being hospitalized or not. The impact of the distance between the patient's home address and the location of both types of services on the patient's choice of service is rather small.
conclusionsInitiatives aiming to lead patients more to PCC by penalizing inappropriate ED use might increase health inequity when they are not twinned with interventions improving the access to primary care services and tackling the underlying mechanisms of patients' emergency care seeking behavior. Further research exploring the impact of out-of-hours care organization (gatekeeping, payment systems, …) and the patient's perspectives on out-of-hours care services is needed.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.