ArticleBMJ open2016
Patient motives behind low-acuity visits to the emergency department in Germany: a qualitative study comparing urban and rural sites.
Article in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 61 papers, 3 of them syntheses that pooled it.
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Who cites it
61 citing papers in PubMed, 3 syntheses or guidelines pooled it, 120 citations in OpenAlex.
- How do interventions in primary care or in emergency departments impact less urgent patients' emergency care utilization? A systematic review.BMC health services research · 2026Pooled it
- ["Triage"-primary assessment of patients in the emergency department : An overview with a systematic review].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2020Pooled it
- Reasons Patients Choose the Emergency Department over Primary Care: a Qualitative Metasynthesis.Journal of general internal medicine · 2019Pooled it
- Clinical Urgency of After-Hours Presentations of Dogs and Cats to a Private Small-Animal Practice in Germany: A Retrospective Study of 4579 Visits.Veterinary sciences · 2026Article
- [Cost and revenue analysis of inpatient and outpatient cases in emergency departments: potential for optimization and control?]Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2026Article
- Appropriateness and utility of a clinical decision support system at the digital front door.NPJ digital medicine · 2026Article
- Factors associated with avoidable non-urgent emergency department visits in South Tyrol (Italy): a multicentre cross-sectional study.BMC emergency medicine · 2026Article
- Article
- Driving factors in pediatric emergency department use: an ecological retrospective study.PloS one · 2026Article
- General Practice-led urgent care practice vs. emergency room - satisfaction of ambulatory patients with low urgency medical problems.The European journal of general practice · 2025Observational
- Why do patients seek emergency care for problems that could be managed in primary care? A scoping review.Family practice · 2025Article
- Article
- Prior Outpatient Care Use in Emergency Department Patients with Low- and High-acuity Conditions in Germany.The western journal of emergency medicine · 2025Article
- Trends in nonurgent mental health presentations to emergency departments: insights from the first nationwide study in Germany.BMC psychiatry · 2025Article
- Article
- Low health literacy is associated with patient-clinician discrepancy in the perceived severity of medical emergencies.Frontiers in public health · 2025Observational
- Observational
- Article
- Experiences of caregivers of patients with noncancer diseases readmitted to an emergency department at the end of life.BMC palliative care · 2024Article
- Evaluating Ocular Healthcare Accessibility and the Severity of Emergencies during Times of Crisis.Journal of clinical medicine · 2024Article
1 more citing papers are in PubMed but not listed here.
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 at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe increasing number of low-acuity visits to emergency departments (ED) is an important issue in Germany, despite the fact that all costs of inpatient and outpatient treatment are covered by mandatory health insurance. We aimed to explore the motives of patients categorised with low-acuity conditions for visiting an ED.
methodsWe conducted a qualitative study in two urban and one rural ED. We recruited a purposive sample of adults, who were assigned to the lowest two categories in the Manchester triage system. One-to-one interviews took place in the ED during patients' waiting time for treatment. Interview transcripts were analysed using the qualitative data management software MAXQDA. A qualitative content analysis approach was taken to identify motives and to compare the rural with the urban sites.
resultsA total of 86 patients were asked to participate; of these, n=15 declined participation and n=7 were excluded because they were admitted as inpatients, leaving a final sample of 40 female and 24 male patients. We identified three pathways leading to an ED visit: (1) without primary care contact, (2) after unsuccessful attempts to see a resident specialist or general practitioner (GP) and (3) recommendation to visit the ED by an outpatient provider. The two essential motives were (1) convenience and (2) health anxiety, triggered by time constraints and focused usage of multidisciplinary medical care in a highly equipped setting. All participants from the rural region were connected to a GP, whom they saw more or less regularly, while more interviewees from the urban site did not have a permanent GP. Still, motives to visit the ED were in general the same.
conclusionsWe conclude that the ED plays a pivotal role in ambulatory acute care which needs to be recognised for adequate resource allocation. TRIAL REGISTRATION NUMBER: DRK S00006053.
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