All Wales Alliance for Research and Development in Health and Social Care Cynghrair Cymru Gyfan ar Gyfer Ymchwil a Datblygiad mewn Iechyd a Gofal Cymdeithasol All Wales Alliance for Research and Development in Health and Social Care Cynghrair Cymru Gyfan ar Gyfer Ymchwil a Datblygiad mewn Iechyd a Gofal Cymdeithasol All Wales Alliance for Research and Development in Health and Social Care Cynghrair Cymru Gyfan ar Gyfer Ymchwil a Datblygiad mewn Iechyd a Gofal Cymdeithasol Understanding How the Public Chooses to Use Unscheduled Care Services Contact: Helen Snooks All Wales Alliance for Research and Development in Health and Social Care Cynghrair Cymru Gyfan ar Gyfer Ymchwil a Datblygiad mewn Iechyd a Gofal Cymdeithasol Project team Alison PorterSwansea University Helen SnooksSwansea University Lori ButtonSwansea University Angela EvansSwansea University Rob Lowe Swansea University Kevin DuffNeath Port Talbot Local Health Board Alan WatkinsSwansea University Adrian EdwardsDepartment of Primary Care, Cardiff University All Wales Alliance for Research and Development in Health and Social Care Cynghrair Cymru Gyfan ar Gyfer Ymchwil a Datblygiad mewn Iechyd a Gofal Cymdeithasol Background Demand for emergency and unscheduled care rising Ageing population Increasing burden of chronic conditions Current system unsustainable But little known about Patterns of unscheduled care services across providers How people make their choices All Wales Alliance for Research and Development in Health and Social Care Cynghrair Cymru Gyfan ar Gyfer Ymchwil a Datblygiad mewn Iechyd a Gofal Cymdeithasol Research aim and objectives To: provide an understanding of the factors which influence members of the public when they make emergency or unscheduled contact with health care services describe patterns of health care seeking behaviour describe the patterns shown by subgroups of the population gain an understanding of the factors that influenced the choice of contact made All Wales Alliance for Research and Development in Health and Social Care Cynghrair Cymru Gyfan ar Gyfer Ymchwil a Datblygiad mewn Iechyd a Gofal Cymdeithasol Methods Questionnaire survey mailed to 4000 adults across Wales In-depth qualitative interviews by phone with 40 people selected from questionnaire respondents Four focus groups: young mothers; people from a Communities First area; Muslim men; older people User representatives involved at all stages in the process All Wales Alliance for Research and Development in Health and Social Care Cynghrair Cymru Gyfan ar Gyfer Ymchwil a Datblygiad mewn Iechyd a Gofal Cymdeithasol Response to questionnaire 1576 questionnaires completed response rate 41.7% 36.8% (n=549) male; 37.0% aged (n=574), 31.4% aged (n=488), 18.7% aged (n=290) 12.9% aged 75 + (n=201) Response rates significantly higher in less deprived areas Questionnaires receivedResponse rate Level 1 (most deprived) % Level % Level % Level % Level 5 (least deprived) % All Wales Alliance for Research and Development in Health and Social Care Cynghrair Cymru Gyfan ar Gyfer Ymchwil a Datblygiad mewn Iechyd a Gofal Cymdeithasol All Wales Alliance for Research and Development in Health and Social Care Cynghrair Cymru Gyfan ar Gyfer Ymchwil a Datblygiad mewn Iechyd a Gofal Cymdeithasol Use of unscheduled care: first point of contact ServiceFrequencyValid percent Family doctor (GP) Out of hours doctors (GP) service397.1 Chemist376.8 Someone else at practice356.4 NHS Direct336.0 Hospital A&E305.5 Dentist ambulance183.3 Hospital clinic or day ward71.3 Minor injury unit61.1 Other including family/friends; telephone hotline; complementary therapy Total responded to this question548100% All Wales Alliance for Research and Development in Health and Social Care Cynghrair Cymru Gyfan ar Gyfer Ymchwil a Datblygiad mewn Iechyd a Gofal Cymdeithasol Number of services contacted for same problem 1 service284.8% 2 services % 3 services % 4 services142.4% 5 services40.7% Total % All Wales Alliance for Research and Development in Health and Social Care Cynghrair Cymru Gyfan ar Gyfer Ymchwil a Datblygiad mewn Iechyd a Gofal Cymdeithasol Health problem for which help or advice sought n% Symptoms of concern Acute infection Accident/Emergency/Morning after pill Long-term/follow up treatment Pain in back/limbs/joints Information/advice/routine tests253.6 Dentistry243.5 Other/unknown/missing537.7 All Wales Alliance for Research and Development in Health and Social Care Cynghrair Cymru Gyfan ar Gyfer Ymchwil a Datblygiad mewn Iechyd a Gofal Cymdeithasol Unscheduled care usage by people with chronic conditions Total contacts 1 contact2 contacts 3-5 contacts 6+ contacts Total contacts Contacts by people with CCs % of contacts by people with CCs All Wales Alliance for Research and Development in Health and Social Care Cynghrair Cymru Gyfan ar Gyfer Ymchwil a Datblygiad mewn Iechyd a Gofal Cymdeithasol What was associated with use of unscheduled health care services? Women more likely to use services than men Living in a more deprived area Having children in the household Having a chronic condition p