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Finding value in 'inappropriate' visits: A new study demonstrates how variation in ED use for preventable visits can be used to detect problems with access to healthcare in our communities
  1. Ellen J Weber
  1. Department of Emergency Medicine, University of California, San Francisco, San Francisco, CA 94143-0749, USA
  1. Correspondence to Dr Ellen J Weber, Emergency Medicine, University of California San Francisco, 505 Parnassus Ave, San Francisco, CA 94143-0208, USA; ellen.weber{at}ucsf.edu

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There is a paper out there that is likely to remain unread by many emergency physicians, in large part because it appears in the journal Health Services Research.1 Yet this study by Sheryl Davies et al is worthy of our attention because it marks a new line of enquiry about those pesky ‘inappropriate’ ED visits. Depending on who you talk to, and probably what time of day it is, emergency physicians are often sympathetic with the patient’s plight, but these visits do add to the overall workload. And so our literature is filled with numerous studies that ask the same question of patients assigned a triaged acuity of 4 or 5, of green or blue: why did you choose to come to the ED (stage whisper: for this minor problem)? We ask questions about transport, do they have a general practitioner (GP), did they call an advice person first; we try to assemble a picture of what they conceive of as an emergency and what their options are. Several patients say their doctor sent them in, others that there was no answer at the doctor’s office, others that the person on the other end of the advice …

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