Does Patient Satisfaction with Primary and Emergency Care Influence Non-Urgent Emergency Department Utilization? A Path Analysis
Journal of Multidisciplinary Healthcare, cilt.18, ss.4703-4715, 2025 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 18
- Basım Tarihi: 2025
- Doi Numarası: 10.2147/jmdh.s532858
- Dergi Adı: Journal of Multidisciplinary Healthcare
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, Directory of Open Access Journals
- Sayfa Sayıları: ss.4703-4715
- Anahtar Kelimeler: emergency medical services, primary health care, patient satisfaction, non-urgent
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Aim: To examine whether patient satisfaction mediates the relationship between primary care (PC) utilization and non-urgent emergency department (ED) use during weekday working hours. Methods: This observational study compared patient satisfaction levels using two validated tools: the EUROPEP (European Patients Evaluate General/Family Practice) scale for PC visits and the Brief Emergency Department Patient Satisfaction Scale (BEPSS) for ED visits. Data analysis was conducted using Jamovi software (version 2.6.26), employing structural equation modeling and correlation analysis. Results: A total of 293 non-urgent adult patients (61.4% female) were enrolled in the study through consecutive sampling at ED visits of a tertiary hospital in Istanbul. Visits solely for examination purposes constituted 43.7% of PC visits and 66.6% of ED visits. Patient satisfaction rates were 66.7% for PC and 75.0% for ED. Frequent users of non-urgent ED services were also more likely to utilize PC services (r = 0.394, p ≤ 0.001). A positive correlation was observed between satisfaction with previous PC and ED experiences (r = 0.399, p ≤ 0.001). However, higher satisfaction with either service was not associated with increased visit frequency (p > 0.05). Notably, frequency of PC visits mediated the relationship between older age and increased non-urgent ED use (β = 0.067, 95% CI [0.002, 0.029], p = 0.028), suggesting insufficient referrals from PC to ED. Conclusion: Non-urgent ED utilization during working hours is not driven by low PC satisfaction or high ED satisfaction. Improving satisfaction alone is insufficient without addressing overuse, maladaptive health-seeking behavior, and the structural need for standardized medical equipment and adequate human resources in family health centers—rather than relying solely on categorical group classifications.