The Hospital Emergency Department as the Primary Source of Medical Care

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Abstract
The role of hospital emergency departments has gradually changed, particularly in large urban areas, where these departments have increasingly become outpatient clinics for everyday ailments rather than centres for the treatment of injuries and emergencies. The main objectives for the present study were: (1) to compare the utilization of district general practitioners and the hospital emergency department by a defined population; (2) estimate how many of the visits to the hospital emergency department are general practitioner-type visits. The results demonstrate the pattern of medical care usage in an area with hospital emergency department services which provide a 24-hour availability and open access, while the primary care services are available only during office hours, are understaffed and have limited access. The study is based on a 1/30 sample (1032 individuals) from the population in the catchment area of a health centre in Stockholm. During the study period (15 months) 30% of the population visited the hospital emergency department, while 15% consulted district general practitioners. Of the visits to the hospital emergency department, 17 per cent were for injuries and between 39 and 64% were general practice-type visits, according to the criteria used in the study.