What is a health emergency? The difference in definition and understanding between patients and health professionals

Abstract

Background. Investigations into ‘inappropriate’ use of emergency health services are limited by the lack of definition of what constitutes a health emergency. Position papers from Australian and international sources emphasise the patient’s right to access emergency healthcare, and the responsibility of emergency health care workers to provide treatment to all patients. However, discordance between the two perspectives remain, with literature labelling patient use of emergency health services as ‘inappropriate’. Objective. To define a ‘health emergency’ and compare patient and health professionals perspectives. Method. A sample of 600 emergency department (ED) patients were surveyed about a recent health experience and asked to rate their perceived urgency. This rating was compared to their triage score allocated at the hospital ED. Results. No significant relationship was found between the two ratings of urgency (P = 0.51). Conclusions. Differing definitions of a ‘health emergency’ may explain patient help-seeking behaviour when accessing emergency health resources including hospital ED and ambulance services. A new definition of health emergency that encapsulates the health professional and patient perspectives is proposed. An agreed definition of when emergency health resources should be used has the potential to improve emergency health services demand and patient flow issues, and optimise emergency health resource allocation. What is known about the topic? Although many patients’ access emergency healthcare services in an emergency, many patients’ access emergency healthcare services when their condition is non-urgent, and avoid using emergency health care when their condition requires. What does this paper add? This paper identifies that health professionals and patients have different perspectives on what constitutes an emergency and when emergency health resources should be used.This paper also provides a review of literature and triage policy papers that identify key differences in the assessment of a health event, and shows that health professionals base their assessment on knowledge and physiological measures, whereas patients used socio-emotional cues to identify medical urgency. What are the implications for practitioners? Practitioners cannot expect their patients to be able to accurately evaluate the urgency of a health event. An emergency is difficult to define as health conditions are dynamic, and may change in urgency over time, and relative urgency is a continuous variable, rather than a dichotomous ‘health emergency’ v. ‘not a health emergency’.