{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T07:07:49Z","timestamp":1761808069935},"reference-count":19,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2016,12,15]],"date-time":"2016-12-15T00:00:00Z","timestamp":1481760000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Evaluation Clinical Practice"],"published-print":{"date-parts":[[2017,6]]},"abstract":"Abstract<\/jats:title>Rationale, aims, and objectives<\/jats:title>There have been multiple studies investigating reasons for patients to self\u2010refer to the Emergency Department (ED). The majority made use of questionnaires and excluded patients with urgent conditions. The goal of this qualitative study is to explore what motives patients have to self\u2010refer to an ED, also including patients in urgent triage categories.<\/jats:p><\/jats:sec>Methods<\/jats:title>In a large teaching hospital in the Netherlands, a qualitative interview study focusing on reasons for self\u2010referring to the ED was performed. Self\u2010referred patients were included until no new reasons for attending the ED were found. Exclusion criteria were as follows: not mentally able to be interviewed or not speaking Dutch. Patients who were in need of urgent care were treated first, before being asked to participate. Interviews followed a predefined topic guide. Practicing cyclic analysis, the interview topic guide was modified during the inclusion period. Interviews were recorded on an audio recorder, transcribed verbatim, and anonymized. Two investigators independently coded the information and combined the codes into meaningful clusters. Subsequently, these were categorized into themes to build a framework of reasons for self\u2010referral to the ED. Characteristic quotes were used to illustrate the acquired theoretical framework.<\/jats:p><\/jats:sec>Results<\/jats:title>Thirty self\u2010referred patients were interviewed. Most of the participants were male (63%), with a mean age of 46\u00a0years. Two main themes emerged from the interviews that are pertinent to the patients' decisions to attend the ED: (1) health concerns and (2) practical issues.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>This study found that there are 2 clearly distinctive reasons for self\u2010referral to the ED: health concerns or practical motives. Self\u2010referral because of practical motives is probably most suitable for strategies that aim to reduce inappropriate ED visits.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jep.12680","type":"journal-article","created":{"date-parts":[[2016,12,15]],"date-time":"2016-12-15T18:24:43Z","timestamp":1481826283000},"page":"593-598","source":"Crossref","is-referenced-by-count":12,"title":["Why patients self\u2010refer to the Emergency Department: A qualitative interview study"],"prefix":"10.1111","volume":"23","author":[{"given":"Nicole","family":"Kraaijvanger","sequence":"first","affiliation":[{"name":"Emergency Department Rijnstate Hospital Arnhem The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douwe","family":"Rijpsma","sequence":"additional","affiliation":[{"name":"Emergency Department Rijnstate Hospital Arnhem The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Willink","sequence":"additional","affiliation":[{"name":"Emergency Department Rijnstate Hospital Arnhem The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Lucassen","sequence":"additional","affiliation":[{"name":"Department of Primary and Community Care Radboud University Medical Centre Nijmegen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henk","family":"van Leeuwen","sequence":"additional","affiliation":[{"name":"Intensive Care\/Internal Medicine Rijnstate Hospital Arnhem The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Edwards","sequence":"additional","affiliation":[{"name":"Surgery Department Radboud University Medical Centre Nijmegen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,12,15]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"A7128.","article-title":"Inventarisatie van SEH\u2010bezoeken en zelfverwijzers [Inventory of attendance at Dutch Emergency Departments and self\u2010referrals]","volume":"158","author":"Gaakeer M","year":"2014","journal-title":"Ned Tijdschr Geneeskd"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/MEJ.0000000000000216"},{"key":"e_1_2_7_4_1","first-page":"587","article-title":"Zelfverwijzers SEH jagen zorgkosten op [self\u2010referrals in the ED raise healthcare costs]","volume":"10","author":"Giesbers S","year":"2011","journal-title":"Medisch 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