The health belief model and use of accident and emergency services by the general public

Abstract

There has been much debate about the use made by the general public of accident and emergency services. A strong element of professional disapproval has been present, as shown by phrases such as 'inappropriate attender'. This paper examines the reasons why people attend accident and emergency and the factors that delay or accelerate attendance, utilizing a framework espoused in the medical sociology literature, i.e. the Health Belief Model. This predicts that individuals carry out a treatment cost-benefit analysis when making decisions about seeking medical assistance. A sample of 200 adult, ambulatory accident and emergency patients was interviewed whilst waiting to see the casualty officer for this study. The data demonstrated that much of the medical, sociological literature concerning patient consultation with doctors is applicable to the accident and emergency situation, in particular the Health Belief Model. A range of factors was shown to make statistically significant differences to the delay times involved in deciding to attend accident and emergency and the time it took to then subsequently attend and register as a patient. These factors also fit the cost-benefit analysis which the Health Benefit Model predicts takes place. Accident and emergency attendance therefore needs to be seen as a logical decision-making process that requires hospitals to provide appropriate services, rather than merely labelling the patients as inappropriate.