• Alexander K Leung, Damiano Loricchio, Robert J Brison, and Karen Graham.
• Resident in the Department of Family Medicine at Queen's University in Kingston, Ont. alexander.leung@dfm.queensu.ca.
• Can Fam Physician. 2019 Jul 1; 65 (7): e305-e310.

ObjectiveTo assess the perceptions of ambulatory patients presenting to the emergency department (ED) of symptom acuity and access to care; the proportion of ambulatory patients who contacted their GPs before attending the ED; and patients' knowledge about whether their GPs provide after-hours or walk-in services.DesignDescriptive survey and proportion test comparisons for data analysis.SettingKingston, Ont.ParticipantsAll ambulatory patients presenting to the ED from December 22, 2016, to January 2, 2017 ("holiday surge" period), and from September 25, 2017, to October 1, 2017 (nonholiday period).Main Outcome MeasuresPatients' perceptions of symptom acuity and access to primary care; proportion of patients who contacted their GPs before attending the ED; and patients' knowledge about their GPs' after-hours or walk-in services.ResultsOverall, 1638 patients during the holiday surge period and 642 patients during the nonholiday period completed the survey (response rate of 54.8% and 38.3%, respectively). Out of all 2280 participants, 530 (23.2%) contacted their GP before going to the ED; 1514 (66.4%) participants decided to go to the ED on their own, and about half of them (795 of 1514 [52.5%]) believed their problem was urgent and could not wait for a GP. A third of all participants (825 of 2280 [36.2%]) believed their GP could have managed their medical problem if they could have gotten an appointment that day. Among a subgroup of participants with a GP, 1095 (52.5%) were aware of off-hour services provided by their GP. There were no statistically significant differences in responses between the holiday and nonholiday periods.ConclusionA large proportion of ambulatory patients would have seen their GP for their medical issue if they thought that they had same-day or next-day access. There is a need for general and emergency physicians to work together on improving access to acute care services.Copyright© the College of Family Physicians of Canada.

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