ArticleBMJ open2019
Understanding people who self-referred in an emergency department with primary care problems during office hours: a qualitative interview study at a Daytime General Practice Cooperative in two hospitals in The Hague, The Netherlands.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 34 citations in OpenAlex.
- Why do patients seek emergency care for problems that could be managed in primary care? A scoping review.Family practice · 2025Article
- Patients' perceptions on reasons for self-referring to the emergency department shortly before a cancer diagnosis: a qualitative study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- Characteristics and reasons non-urgent self-referred patients visit the emergency department in Kimberley, South Africa.Health SA = SA Gesondheid · 2025Article
- Emergency department visits as a potential opportunity to promote primary care attachment and modify utilization patterns - results of a pilot study in Berlin, Germany.BMC emergency medicine · 2024Article
- "I do not know the advantages of having a general practitioner" - a qualitative study exploring the views of low-acuity emergency patients without a regular general practitioner toward primary care.BMC health services research · 2024Article
- A prospective study to evaluate the contribution of the pediatric appendicitis score in the decision process.BMC pediatrics · 2024Article
- Do patients referred to emergency departments after being assessed in primary care differ from other ED patients? Retrospective analysis of a random sample from two German metropolitan EDs.International journal of emergency medicine · 2023Article
- Article
- A methodological framework for evaluating transitions in acute care services in the Netherlands to achieve Triple Aim.BMC research notes · 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
- Recent trends and variations in general practitioners' involvement in accident care in Switzerland: an analysis of claims data.BMC family practice · 2020Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo provide insight into the motives for hospital self-referral during office hours and the barriers deterring general practitioner (GP) consultation with a primary care request.
settingPeople who self-referred at a Daytime General Practice Cooperative (GPC) in two hospitals in The Hague, The Netherlands.
participantsA total of 44 people who self-referred were interviewed in two hospitals. The average age of interviewees was 35 years (range 19 months to 83 years), a parent of a young patient was interviewed, but the age of patients is shown here. There were more male patients (66%) than female patients (34%). Patients were recruited using a sampling method after triage. Triage was the responsibility of an emergency department (ED) nurse in one hospital and of a GP in the other. Those excluded from participation included (a) children under the age of 18 years and not accompanied by a parent or legal guardian, (b) foreign patients not resident in the Netherlands, (c) patients unable to communicate in Dutch or English and (d) patients directly referred to the ED after triage by the GP (in one hospital).
resultsPeople who self-referred generally reported several motives for going to the hospital directly. Information and awareness factors played an important role, often related to a lack of information regarding where to go with a medical complaint. Furthermore, many people who self-referred mentioned hospital facilities, convenience and perceived medical necessity as motivational factors. Barriers deterring a visit to the own GP were mainly logistical, including not being registered with a GP, the GP was too far away, poor GP telephone accessibility or a waiting list for an appointment.
conclusionInformation and awareness factors contribute to misperceptions among people who self-referred concerning the complaint, the GP and the hospital. As a range of motivational factors are involved, there is no straightforward solution. However, better dissemination of information might alleviate misconceptions and contribute to providing the right care to the right patient in the right setting.
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