A cohort study of influences, health outcomes and costs of patients' health-seeking behaviour for minor ailments from primary and emergency care settings

Watson, M C and Ferguson, J and Barton, G R and Maskrey, V and Blyth, A and Paudyal, V and Bond, C M and Holland, R and Porteous, T and Sach, T H and Wright, D and Fielding, S (2015) A cohort study of influences, health outcomes and costs of patients' health-seeking behaviour for minor ailments from primary and emergency care settings. BMJ Open, 5. e006261. ISSN 2044-6055

[thumbnail of Watson-etal-BMJ-Open-2014-A-cohort-study-of-influences-health-outcomes-and-costs-of-patients-health-seeking-behaviour]
Preview
 Text. Filename: Watson_etal_BMJ_Open_2014_A_cohort_study_of_influences_health_outcomes_and_costs_of_patients_health_seeking_behaviour.pdf
Final Published Version
License: Creative Commons Attribution-NonCommercial 4.0 logo
Download (1MB)| Preview

    Abstract

    Objectives To compare health-related and cost-related outcomes of consultations for symptoms suggestive of minor ailments in emergency departments (EDs), general practices and community pharmacies.Design Observational study; prospective cohort design.Setting EDs (n=2), general practices (n=6) and community pharmacies (n=10) in a mix of rural/urban and deprived/affluent areas across North East Scotland and East Anglia. Participants Adults (≥18 years) presenting between 09:00 and 18:00 (Monday–Friday) in general practices and 09:00–18:00 (Monday–Saturday) in pharmacies and EDs with ≥1 of the following: musculoskeletal pain; eye discomfort; gastrointestinal disturbance; or upper respiratory tract-related symptoms.Interventions Participants completed three questionnaires: baseline (prior to index consultation); satisfaction with index consultation and follow-up (2 weeks after index consultation).Main outcome measures Symptom resolution, quality of life, costs, satisfaction and influences on care-seeking behaviour.Results 377 patients participated, recruited from EDs (81), general practices (162) and community pharmacies (134). The 2-week response rate was 70% (264/377). Symptom resolution was similar across all three settings: ED (37.3%), general practice (35.7%) and pharmacy (44.3%). Mean overall costs per consultation were significantly lower for pharmacy (£29.30 (95% CI £21.60 to £37.00)) compared with general practice (£82.34 (95% CI £63.10 to £101.58)) and ED (£147.09 (95% CI £125.32 to £168.85)). Satisfaction varied across settings and by measure used. Compared with pharmacy and general practice use, ED use was significantly (p

    ORCID iDs

    Watson, M C ORCID logoORCID: https://orcid.org/0000-0002-8198-9273, Ferguson, J, Barton, G R, Maskrey, V, Blyth, A, Paudyal, V, Bond, C M, Holland, R, Porteous, T, Sach, T H, Wright, D and Fielding, S;
    CORE (COnnecting REpositories)