Articles: hospital-emergency-service.
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The impact of the introduction of Medicare in Quebec on hospital emergency room services was examined in Metropolitan Montreal. After Medicare, the emergency room visit rate increased 14 per cent per year compared to a 7 per cent per year increase in the five years preceding Medicare. The outpatient clinic visit rate continued an upward trend (4 per cent per year). ⋯ Before Medicare, 47 per cent of patients said that their usual source of care was a private physician, and only 17 per cent usually sought care in the emergency room. After Medicare 58 per cent reported a private physician and 31 per cent the emergency room. These findings together with the increased population density of physicians and increased annual number of physician visits per person suggest that there has been a substantial rise in demand from the public for medical care of which one important early manifestation is an increased reliance on emergency rooms.
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We examined six factors that may help to explain why parents take their children to hospital emergency departments: arrival time; travel time; who decided the patient should go; did the patient have a physician; did the parent attempt physician contact, and where the parent would have preferred to have gone for treatment. Results indicate that 47% of the nonemergency visits occurred during the time when physicians maintain office hours. Most visits were made by patients living less than 15 minutes away from the hospital. ⋯ Most parents did not try to contact a physician prior to the visit. Indeed, 46% of the parents preferred to take their children to the emergency department rather than to a physician's office. Finally, 74% of the parents who attempted some contact with a member of the health care system were referred to the emergengy department for care.