Hospital Emergency Departments: Substitute for Primary Care? Results of a Survey among the Population of Montréal and Montérégie
Almost one-third (31%) of the adult population in Montréal and Montérégie reported going to emergency departments at least once in the two years preceding the survey. Utilisation of emergency departments varies by health and social services centre (CSSS, Centre de santé et de services sociaux) territory, and tends to be higher in rural areas. This could be related to the specific pattern of organisation of primary care practices in rural areas. Having a regular source of primary care and perceiving to have rapid access to a primary care physician are associated to reduced use of emergency departments. The survey also reveals higher proportions of emergency department utilisation among people reporting poorer health status, young adults, socio-economically disadvantaged individuals, and recent immigrants.
Among people who reported a health problem in the past six months, one out of three identified an emergency department as their primary source of medical advice for this problem. A number of elements are involved in the decision to go to emergency departments when a health problem occurs. Perception of the level of urgency and severity of the health problem as well as recommendations from health professional consulted are important factors. The individual’s choice to go to emergency departments is also influenced by the perception that access to primary care services is limited. Going to emergency departments is also seen as a way to gain quicker access to specialised services and to resources to meet the individual’s overall health needs.
In the current context, hospital emergency departments provide an important safety net to meet the immediate health care needs of individuals who do not have a regular source of care or who are unable to gain rapid access to primary care services.