A cohort study of influences, health outcomes and costs of patients' health-seeking behaviour for minor ailments from primary and emergency care settings

M C Watson; G R Barton; V Maskrey; A Blyth; Vibhu Paudyal; C M Bond; R Holland; T Porteous; T H Sach; D Wright; S Fielding; James Ferguson

doi:10.1136/bmjopen-2014-006261

A cohort study of influences, health outcomes and costs of patients' health-seeking behaviour for minor ailments from primary and emergency care settings

M C Watson, G R Barton, V Maskrey, A Blyth, Vibhu Paudyal, C M Bond, R Holland, T Porteous, T H Sach, D Wright, S Fielding, James Ferguson

Research output: Contribution to journal › Article › peer-review

104 Citations (Scopus)

Abstract

OBJECTIVES: To compare health-related and cost-related outcomes of consultations for symptoms suggestive of minor ailments in emergency departments (EDs), general practices and community pharmacies.DESIGN: Observational study; prospective cohort design.SETTING: EDs (n=2), general practices (n=6) and community pharmacies (n=10) in a mix of rural/urban and deprived/affluent areas across North East Scotland and East Anglia. Participants Adults (≥18 years) presenting between 09:00 and 18:00 (Monday-Friday) in general practices and 09:00-18:00 (Monday-Saturday) in pharmacies and EDs with ≥1 of the following: musculoskeletal pain; eye discomfort; gastrointestinal disturbance; or upper respiratory tract-related symptoms.INTERVENTIONS: Participants completed three questionnaires: baseline (prior to index consultation); satisfaction with index consultation and follow-up (2 weeks after index consultation).MAIN OUTCOME MEASURES: Symptom resolution, quality of life, costs, satisfaction and influences on care-seeking behaviour.RESULTS: 377 patients participated, recruited from EDs (81), general practices (162) and community pharmacies (134). The 2-week response rate was 70% (264/377). Symptom resolution was similar across all three settings: ED (37.3%), general practice (35.7%) and pharmacy (44.3%). Mean overall costs per consultation were significantly lower for pharmacy (£29.30 (95% CI £21.60 to £37.00)) compared with general practice (£82.34 (95% CI £63.10 to £101.58)) and ED (£147.09 (95% CI £125.32 to £168.85)). Satisfaction varied across settings and by measure used. Compared with pharmacy and general practice use, ED use was significantly (p

Original language	English
Journal	BMJ Open
Volume	5
Issue number	2
DOIs	https://doi.org/10.1136/bmjopen-2014-006261
Publication status	Published - 18 Feb 2015

Keywords

Adult
Aged
Costs and Cost Analysis
Emergency Medical Services
Emergency Treatment
England
Female
Gastrointestinal Diseases
General Practice
Health Behavior
Humans
Male
Middle Aged
Musculoskeletal Pain
Patient Acceptance of Health Care
Patient Satisfaction
Pharmacies
Primary Health Care
Prospective Studies
Quality of Life
Respiratory Tract Diseases
Scotland
Severity of Illness Index
State Medicine
Surveys and Questionnaires
Journal Article
Research Support, Non-U.S. Gov't

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10.1136/bmjopen-2014-006261

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Watson, M. C., Barton, G. R., Maskrey, V., Blyth, A., Paudyal, V., Bond, C. M., Holland, R., Porteous, T., Sach, T. H., Wright, D., Fielding, S., & Ferguson, J. (2015). A cohort study of influences, health outcomes and costs of patients' health-seeking behaviour for minor ailments from primary and emergency care settings. BMJ Open, 5(2). https://doi.org/10.1136/bmjopen-2014-006261

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abstract = "OBJECTIVES: To compare health-related and cost-related outcomes of consultations for symptoms suggestive of minor ailments in emergency departments (EDs), general practices and community pharmacies.DESIGN: Observational study; prospective cohort design.SETTING: EDs (n=2), general practices (n=6) and community pharmacies (n=10) in a mix of rural/urban and deprived/affluent areas across North East Scotland and East Anglia. Participants Adults (≥18 years) presenting between 09:00 and 18:00 (Monday-Friday) in general practices and 09:00-18:00 (Monday-Saturday) in pharmacies and EDs with ≥1 of the following: musculoskeletal pain; eye discomfort; gastrointestinal disturbance; or upper respiratory tract-related symptoms.INTERVENTIONS: Participants completed three questionnaires: baseline (prior to index consultation); satisfaction with index consultation and follow-up (2 weeks after index consultation).MAIN OUTCOME MEASURES: Symptom resolution, quality of life, costs, satisfaction and influences on care-seeking behaviour.RESULTS: 377 patients participated, recruited from EDs (81), general practices (162) and community pharmacies (134). The 2-week response rate was 70% (264/377). Symptom resolution was similar across all three settings: ED (37.3%), general practice (35.7%) and pharmacy (44.3%). Mean overall costs per consultation were significantly lower for pharmacy (£29.30 (95% CI £21.60 to £37.00)) compared with general practice (£82.34 (95% CI £63.10 to £101.58)) and ED (£147.09 (95% CI £125.32 to £168.85)). Satisfaction varied across settings and by measure used. Compared with pharmacy and general practice use, ED use was significantly (p",

keywords = "Adult, Aged, Costs and Cost Analysis, Emergency Medical Services, Emergency Treatment, England, Female, Gastrointestinal Diseases, General Practice, Health Behavior, Humans, Male, Middle Aged, Musculoskeletal Pain, Patient Acceptance of Health Care, Patient Satisfaction, Pharmacies, Primary Health Care, Prospective Studies, Quality of Life, Respiratory Tract Diseases, Scotland, Severity of Illness Index, State Medicine, Surveys and Questionnaires, Journal Article, Research Support, Non-U.S. Gov't",

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Watson, MC, Barton, GR, Maskrey, V, Blyth, A, Paudyal, V , Bond, CM , Holland, R, Porteous, T, Sach, TH, Wright, D, Fielding, S & Ferguson, J 2015, 'A cohort study of influences, health outcomes and costs of patients' health-seeking behaviour for minor ailments from primary and emergency care settings', BMJ Open, vol. 5, no. 2. https://doi.org/10.1136/bmjopen-2014-006261

TY - JOUR

T1 - A cohort study of influences, health outcomes and costs of patients' health-seeking behaviour for minor ailments from primary and emergency care settings

AU - Watson, M C

AU - Barton, G R

AU - Maskrey, V

AU - Blyth, A

AU - Paudyal, Vibhu

AU - Bond, C M

AU - Holland, R

AU - Porteous, T

AU - Sach, T H

AU - Wright, D

AU - Fielding, S

AU - Ferguson, James

N1 - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions. M1 - e006261

PY - 2015/2/18

Y1 - 2015/2/18

N2 - OBJECTIVES: To compare health-related and cost-related outcomes of consultations for symptoms suggestive of minor ailments in emergency departments (EDs), general practices and community pharmacies.DESIGN: Observational study; prospective cohort design.SETTING: EDs (n=2), general practices (n=6) and community pharmacies (n=10) in a mix of rural/urban and deprived/affluent areas across North East Scotland and East Anglia. Participants Adults (≥18 years) presenting between 09:00 and 18:00 (Monday-Friday) in general practices and 09:00-18:00 (Monday-Saturday) in pharmacies and EDs with ≥1 of the following: musculoskeletal pain; eye discomfort; gastrointestinal disturbance; or upper respiratory tract-related symptoms.INTERVENTIONS: Participants completed three questionnaires: baseline (prior to index consultation); satisfaction with index consultation and follow-up (2 weeks after index consultation).MAIN OUTCOME MEASURES: Symptom resolution, quality of life, costs, satisfaction and influences on care-seeking behaviour.RESULTS: 377 patients participated, recruited from EDs (81), general practices (162) and community pharmacies (134). The 2-week response rate was 70% (264/377). Symptom resolution was similar across all three settings: ED (37.3%), general practice (35.7%) and pharmacy (44.3%). Mean overall costs per consultation were significantly lower for pharmacy (£29.30 (95% CI £21.60 to £37.00)) compared with general practice (£82.34 (95% CI £63.10 to £101.58)) and ED (£147.09 (95% CI £125.32 to £168.85)). Satisfaction varied across settings and by measure used. Compared with pharmacy and general practice use, ED use was significantly (p

AB - OBJECTIVES: To compare health-related and cost-related outcomes of consultations for symptoms suggestive of minor ailments in emergency departments (EDs), general practices and community pharmacies.DESIGN: Observational study; prospective cohort design.SETTING: EDs (n=2), general practices (n=6) and community pharmacies (n=10) in a mix of rural/urban and deprived/affluent areas across North East Scotland and East Anglia. Participants Adults (≥18 years) presenting between 09:00 and 18:00 (Monday-Friday) in general practices and 09:00-18:00 (Monday-Saturday) in pharmacies and EDs with ≥1 of the following: musculoskeletal pain; eye discomfort; gastrointestinal disturbance; or upper respiratory tract-related symptoms.INTERVENTIONS: Participants completed three questionnaires: baseline (prior to index consultation); satisfaction with index consultation and follow-up (2 weeks after index consultation).MAIN OUTCOME MEASURES: Symptom resolution, quality of life, costs, satisfaction and influences on care-seeking behaviour.RESULTS: 377 patients participated, recruited from EDs (81), general practices (162) and community pharmacies (134). The 2-week response rate was 70% (264/377). Symptom resolution was similar across all three settings: ED (37.3%), general practice (35.7%) and pharmacy (44.3%). Mean overall costs per consultation were significantly lower for pharmacy (£29.30 (95% CI £21.60 to £37.00)) compared with general practice (£82.34 (95% CI £63.10 to £101.58)) and ED (£147.09 (95% CI £125.32 to £168.85)). Satisfaction varied across settings and by measure used. Compared with pharmacy and general practice use, ED use was significantly (p

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KW - Aged

KW - Costs and Cost Analysis

KW - Emergency Medical Services

KW - Emergency Treatment

KW - England

KW - Female

KW - Gastrointestinal Diseases

KW - General Practice

KW - Health Behavior

KW - Humans

KW - Male

KW - Middle Aged

KW - Musculoskeletal Pain

KW - Patient Acceptance of Health Care

KW - Patient Satisfaction

KW - Pharmacies

KW - Primary Health Care

KW - Prospective Studies

KW - Quality of Life

KW - Respiratory Tract Diseases

KW - Scotland

KW - Severity of Illness Index

KW - State Medicine

KW - Surveys and Questionnaires

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

U2 - 10.1136/bmjopen-2014-006261

DO - 10.1136/bmjopen-2014-006261

M3 - Article

SN - 2044-6055

VL - 5

JO - BMJ Open

JF - BMJ Open

IS - 2

ER -

A cohort study of influences, health outcomes and costs of patients' health-seeking behaviour for minor ailments from primary and emergency care settings

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Keywords

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