ArticleBMJ quality & safety2020
Factors associated with inappropriate use of emergency departments: findings from a cross-sectional national study in France.
Article in BMJ quality & safety, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 1 of them a synthesis that pooled it.
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Who cites it
39 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Distances to emergency departments and non-urgent utilization of medical services: a systematic review.Global health action · 2024Pooled it
- EPOCA Tele-Monitoring System for Older Adults at High Risk of Hospitalization: Budget Impact and Cost-Effectiveness Analysis.Journal of medical Internet research · 2026Article
- Changes in the Patterns of Emergency Ambulance Care During a Primary Care Model Programme in Hungary.Healthcare (Basel, Switzerland) · 2026Article
- Factors associated with avoidable non-urgent emergency department visits in South Tyrol (Italy): a multicentre cross-sectional study.BMC emergency medicine · 2026Article
- Avoidable emergency department admissions among nursing home residents - insights from a retrospective study.European geriatric medicine · 2026Article
- Factors influencing emergency department utilisation using Andersen's behavioural model: a cross-sectional study in a public hospital in Malaysia.Frontiers in public health · 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
- Article
- Impact of a Home-Based Remote Patient Monitoring System on Hospitalizations and Emergency Department Visits of Older Adults With Polypathology: Multicenter Retrospective Observational Study.Journal of medical Internet research · 2025Observational
- Trends in nonurgent mental health presentations to emergency departments: insights from the first nationwide study in Germany.BMC psychiatry · 2025Article
- Effect of COVID-19 and other determinants on the reduction of non-urgent emergency department access in North-East Italy: does supply affect demand?Research in health services & regions · 2025Article
- Remote Patient Monitoring System for Polypathological Older Adults at High Risk for Hospitalization: Retrospective Cohort Study.Journal of medical Internet research · 2025Article
- Pragmatic Risk Stratification Method to Identify Emergency Department Presentations for Alternative Care Service Pathways: Registry-Based Retrospective Study Over 5 Years.Journal of medical Internet research · 2025Article
- Factors associated with hospital revisitation within 7 days among patients discharged at triage: a case-control study.European journal of emergency medicine : official journal of the European Society for Emergency Medicine · 2025Observational
- Impact of the Implementation of a Short Stay Observation Unit Associated With Admitter-Rounder Model Onto Other Internal Medicine Units in a French University Hospital.Journal of evaluation in clinical practice · 2025Article
- Redirection of low-acuity emergency department patients to nearby medical clinics using an electronic medical support system: effects on emergency department performance indicators.BMC emergency medicine · 2024Observational
- Social inequalities in medical appointment cancellations and reschedulings at the onset of the COVID-19 epidemic in France.European journal of public health · 2024Article
- Article
- Decreasing hospitalizations through geriatric hotlines: a prospective French multicenter study of people aged 75 and above.BMC geriatrics · 2023Observational
- 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
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7 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundInappropriate visits to emergency departments (EDs) could represent from 20% to 40% of all visits. Inappropriate use is a burden on healthcare costs and increases the risk of ED overcrowding. The aim of this study was to explore socioeconomic and geographical determinants of inappropriate ED use in France.
methodThe French Emergency Survey was a nationwide cross-sectional survey conducted on June 11 2013, simultaneously in all EDs in France and covered characteristics of patients, EDs and counties. The survey included 48 711 patient questionnaires and 734 ED questionnaires. We focused on adult patients (≥15 years old). The appropriateness of the ED visit was assessed by three measures: caring physician appreciation of appropriateness (numeric scale), caring physician appreciation of whether or not the patient could have been managed by a general practitioner and ED resource utilisation. Descriptive statistics and multilevel logistic regression were used to examine determinants of inappropriate ED use, estimating adjusted ORs and 95% CIs.
resultsAmong the 29 407 patients in our sample, depending on the measuring method, 13.5% to 27.4% ED visits were considered inappropriate. Regardless of the measure method used, likelihood of inappropriate use decreased with older age and distance from home to the ED >10 km. Not having a private supplementary health insurance, having universal supplementary health coverage and symptoms being several days old increased the likelihood of inappropriate use. Likelihood of inappropriate use was not associated with county medical density.
conclusionInappropriate ED use appeared associated with socioeconomic vulnerability (such as not having supplementary health coverage or having universal coverage) but not with geographical characteristics. It makes us question the appropriateness of the concept of inappropriate ED use as it does not consider the distress experienced by the patient, and segments of society seem to have few other choices to access healthcare than the ED.
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