Nearly 20 disadvantaged households across the North West (UK) were surveyed to study the social reasons behind people attending their local Accident & Emergency department.
Researchers from the University of Liverpool, supported by the National Institute for Health Research (NIHR), conducted a household health survey including over 3,500 face-to-face interviews with households randomly selected in communities across Lancashire, Cheshire and Merseyside.
‘A&E attendances are mainly high in the disadvantaged areas with the lack of jobs and poor housing being the principal reasons behind increased A&E attendances.’
31% of survey respondents had attended A&E in the previous 12 months with individual attendance rates ranging between 1 and 95 visits. Age was a big factor in potential visits, with 18-26 year olds three times more likely to attend A&E compared to those above 64 years of age.
Other outputs from the research, published in the online journal BMJ Open
, suggested a lack of a job increased the likelihood of A&E attendance by 38% and poor housing conditions increased attendance by 34%.
Participants were asked to complete general background about their physical health, mental health, lifestyle, social issues, housing, environment, finances and local health service usage. Households were approached at different times during the day to ensure a mix of sample participants.
Depression, a need for help with personal care, access to public transport and household proximity to A&E departments were other key factors found to influence an individual's decision on whether to attend. Those living closer to an A&E department also formed a higher proportion of attendees while the distance from their local GP surgery could also influence a decision to attend.
Dr Clarissa Giebel, a Research Manager at the University of Liverpool, said: "This is one of the first surveys to explore a comprehensive set of socio-economic factors, as well as proximity to both GP and A&E services, as predictors of A&E attendance in disadvantaged areas.
"A&E attendance rates are rapidly on the increase and are particularly high in disadvantaged areas.
"In order to reduce A&E attendances we need to consider wider factors communities are facing. Inequalities around employment and housing are an important part of understanding the motivations for attendance levels and there is a clear need for closer consideration of the placement of primary care services and ensuring clearer public access routes to them."
The research also identified that higher levels of education were associated with an increased likelihood of A&E attendance and having more than one illness did not automatically mean people would be more likely to attend A&E, when compared to someone with a single condition.