TY  - JOUR
PY  - 2019//
TI  - What are the social predictors of accident and emergency attendance in disadvantaged neighbourhoods? Results from a cross-sectional household health survey in the north west of England
JO  - BMJ open
A1  - Giebel, Clarissa
A1  - McIntyre, Jason Cameron
A1  - Daras, Konstantinos
A1  - Gabbay, Mark
A1  - Downing, Jennifer
A1  - Pirmohamed, Munir
A1  - Walker, Fran
A1  - Sawicki, Wojciech
A1  - Alfirevic, Ana
A1  - Barr, Ben
SP  - e022820
EP  - e022820
VL  - 9
IS  - 1
N2  - OBJECTIVES: The aim of this study was to identify the most important determinants of accident and emergency (A&E) attendance in disadvantaged areas. DESIGN, SETTING AND PARTICIPANTS: A total of 3510 residents from 20 disadvantaged neighbourhoods in the North West Coast area in England completed a comprehensive public health survey. MAIN OUTCOME MEASURES: Participants were asked to complete general background information, as well as information about their physical health, mental health, lifestyle, social issues, housing and environment, work and finances, and healthcare service usage. Only one resident per household could take part in the survey. Poisson regression analysis was employed to assess the predictors of A&E attendance frequency in the previous 12 months. <br><br>RESULTS: 31.6% of the sample reported having attended A&E in the previous 12 months, ranging from 1 to 95 visits. Controlling for demographic and health factors, not being in employment and living in poor quality housing increased the likelihood of attending an A&E service. Service access was also found to be predictive of A&E attendance insofar as there were an additional 18 fewer A&E attendances per 100 population for each kilometre closer a person lived to a general practitioner (GP) practice, and 3 fewer attendances per 100 population for each kilometre further a person lived from an A&E department. <br><br>CONCLUSIONS: 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. <br><br>FINDINGS from this study suggest the need to address both socioeconomic issues, such as employment and housing quality, as well as structural issues, such as public transport and access to primary care, to reduce the current burden on A&E departments.<br><br>© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ.<p />  <p>Language: en</p>
LA  - en
SN  - 2044-6055
UR  - http://dx.doi.org/10.1136/bmjopen-2018-022820
ID  - ref1
ER  -