• Ghasem Sam Toloo, Gerry J FitzGerald, Peter J Aitken, Joseph Y S Ting, Kirsten McKenzie, Joanna Rego, and Emma Enraght-Moony.
• School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia. sam.toloo@qut.edu.au
• Acad Emerg Med. 2013 Jun 1;20(6):576-83.

ObjectivesThe objective was to study the role and effect of patients' perceptions on reasons for using ambulance services in Queensland, Australia.MethodsA cross-sectional survey was conducted of patients (n = 911) presenting via ambulance or self-transport at eight public hospital emergency departments (EDs). The survey included perceived illness severity, attitudes toward ambulance, and reasons for using ambulance. A theoretical framework was developed to inform this study.ResultsAmbulance users had significantly higher self-rated perceived seriousness, urgency, and pain than self-transports. They were also more likely to agree that ambulance services are for everyone to use, regardless of the severity of their conditions. In compared to self-transports, likelihood of using an ambulance increased by 26% for every unit increase in perceived seriousness; and patients who had not used an ambulance in the 6 months prior to the survey were 66% less likely to arrive by ambulance. Patients who had presented via ambulance stated they considered the urgency (87%) or severity (84%) of their conditions as reasons for calling the ambulance. Other reasons included requiring special care (76%), getting higher priority at the ED (34%), not having a car (34%), and financial concerns (17%).ConclusionsUnderstanding patients' perceptions is essential in explaining their actions and developing safe and effective health promotion programs. Individuals use ambulances for various reasons and justifications according to their beliefs, attitudes, and sociodemographic conditions. Policies to reduce and manage demand for such services need to address both general opinions and specific attitudes toward emergency health services to be effective.© 2013 by the Society for Academic Emergency Medicine.

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