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New research identifies social factors influencing why people attend A&E


A survey of 20 disadvantaged neighbourhoods across the North West has revealed the social influences on why people attend their local Accident & Emergency department.

The research found that 18-26 year olds are three times more likely to attend A&E compared to those above 64 years of age. A lack of a job increased the likelihood of A&E attendance by 38%, and poor housing conditions increased attendance by 34%.

Researchers from the University of Liverpool, supported by the NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) North West Coast, conducted a survey, including over 3,500 face-to-face interviews, with households in communities across Lancashire, Cheshire and Merseyside.

Participants were asked to complete general background about their physical health, mental health, lifestyle, social issues, housing, environment, finances and local health service usage. Households were approached at different times during the day to ensure a mix of sample participants.

The research, published in BMJ Open, found that 31% of survey respondents had attended A&E in the previous 12 months with individual attendance rates ranging between 1 and 95 visits.

Depression, a need for help with personal care, access to public transport and household proximity to A&E departments were other key factors found to influence an individual’s decision on whether to attend. Those living closer to an A&E department also formed a higher proportion of attendees while the distance from their local GP surgery could also influence a decision to attend.

Dr Clarissa Giebel, an NIHR Research Manager at the University of Liverpool, said: “This is one of the first surveys to explore a comprehensive set of socio-economic factors, as well as proximity to both GP and A&E services, as predictors of A&E attendance in disadvantaged areas

“In order to reduce A&E attendances we need to consider wider factors communities are facing. Inequalities around employment and housing are an important part of understanding the motivations for attendance levels and there is a clear need for closer consideration of the placement of primary care services and ensuring clearer public access routes to them.”

Professor Mark Gabbay, Director NIHR CLAHRC NWC and Professor of General Practice at the University, said: “These results are important for frontline and community services to digest and use to plan future services so we can tackle health inequalities identified in the research. We will be sharing the results through a series of local learning exchange workshops with our Partners, including Local Authorities and NHS outlets, and be inviting along representatives from the participating communities.”

“I am also proud to say members of the public have been directly involved in the compilation of the research and its resulting publications.”

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