Tendency to call an ambulance or attend an emergency department for minor or non-urgent problems: a vignette-based population survey in Britain

Background: There are concerns about high levels of demand for emergency health services. The aim was to identify the characteristics of the British population with a tendency to contact emergency medical services and EDs for minor or non-urgent problems.

Methods: A survey of the British adult population in 2018. Six vignettes were constructed about illness in adults (cough/sore throat or diarrhoea/vomiting), injury in adults (sore rib or back pain) and fever in children (occurring weekday or weekend).

Results: The response rate was 42%, with 2906 respondents. 11% (319/2716) of respondents selected to contact an ambulance and 43% ED, mainly for the vignettes about fever in children and sore rib. Males, people from ethnic minority communities and older people had a tendency to contact emergency services for minor problems. Tendency to call an ambulance was also characterised by ‘low resources’ (manual or unskilled occupations, no car, low health literacy), worry that a symptom might be serious, distress (feeling overwhelmed by health problems) and frequent use of EDs. For EDs, there was an attraction to EDs because of availability of tests.

Conclusion: Whereas use of emergency ambulances for minor or non-urgent problems appeared to be driven by people’s lack of resources, including lack of transport, use of EDs appeared to be driven by their attractive characteristic of offering tests quickly.