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Keywords:

  • emergency and urgent care;
  • health care quality assessment;
  • health care systems;
  • patient satisfaction

Abstract

Background  Surveys of patients’ experiences and views of health care usually focus on single services. During an unexpected episode of ill health, patients may make contact with different services and therefore experience care within an emergency and urgent care system. We developed the Urgent Care System Questionnaire and used it to describe patients’ experiences and views of an emergency and urgent care system in England.

Methods  A market research company used quota sampling and random digit dialling to undertake a telephone survey of 1000 members of the general population in July 2007.

Results  15% (151/1000) of the population reported using the emergency and urgent care system in the previous 3 months. Two thirds of users (68%, 98/145) contacted more than one service for their most recent event, with a mean of 2.0 services per event. Users entered the system through a range of services: the majority contacted a daytime GP in the first instance (59%, 85/145), and 12% (18/145) contacted either a 999 emergency ambulance or an emergency department. Satisfaction with all aspects of care diminished when four or more services had been contacted.

Conclusions  This is the first study to describe patients’ experiences and views of the emergency and urgent care system. The majority of patients experienced a system of care rather than single service care. There was an indication that longer pathways resulted in lower levels of patient satisfaction. Health care organisations can undertake similar surveys to identify problems with their system or to assess the impact of changes made to their system.